Healthcare Provider Details

I. General information

NPI: 1215958087
Provider Name (Legal Business Name): PINNACLE HEALTH FACILITIES OF TEXAS XIV LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LINCOLN PARK DR
CLEBURNE TX
76033-7016
US

IV. Provider business mailing address

5420 W PLANO PKWY
PLANO TX
75093-4823
US

V. Phone/Fax

Practice location:
  • Phone: 817-645-0400
  • Fax: 871-641-7132
Mailing address:
  • Phone: 972-931-3800
  • Fax: 972-767-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JAMIE LATTURE COLLIER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 972-931-3800