Healthcare Provider Details

I. General information

NPI: 1275857930
Provider Name (Legal Business Name): PCDI HEALTHCARE AND CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 UPTOWN BLVD SUITE 2000
CEDAR HILL TX
75104-3527
US

IV. Provider business mailing address

610 UPTOWN BLVD SUITE 2000
CEDAR HILL TX
75104-3527
US

V. Phone/Fax

Practice location:
  • Phone: 469-523-1395
  • Fax:
Mailing address:
  • Phone: 469-523-1395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY D WALLACE
Title or Position: EXECUTIVE ADMINISTRATOR
Credential: RNA
Phone: 469-523-1395