Healthcare Provider Details

I. General information

NPI: 1821163932
Provider Name (Legal Business Name): HEALTHCARE MANAGEMENT PARTNERS OF DALLAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 E LOOP 304
CROCKETT TX
75835-1810
US

IV. Provider business mailing address

201 HOLLYWOOD BLVD
BIRMINGHAM AL
35209-2016
US

V. Phone/Fax

Practice location:
  • Phone: 936-544-2051
  • Fax: 936-544-8981
Mailing address:
  • Phone: 615-584-0719
  • Fax: 615-523-1835

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: MR. DEREK PIERCE
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 615-584-0719