Healthcare Provider Details

I. General information

NPI: 1659644185
Provider Name (Legal Business Name): SCC PARTNERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2012
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 15TH ST
BRIDGEPORT TX
76426-2055
US

IV. Provider business mailing address

1413 E I 30 SUITE 7
GARLAND TX
75043-4784
US

V. Phone/Fax

Practice location:
  • Phone: 940-683-5023
  • Fax: 940-683-3184
Mailing address:
  • Phone: 972-303-7500
  • Fax: 972-303-9700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SHANE LEWIS
Title or Position: VP
Credential:
Phone: 972-303-7500