Healthcare Provider Details

I. General information

NPI: 1801485537
Provider Name (Legal Business Name): MSL DENISON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2021
Last Update Date: 01/17/2021
Certification Date: 01/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E US HIGHWAY 69
DENISON TX
75021-6510
US

IV. Provider business mailing address

601 E US HIGHWAY 69
DENISON TX
75021-6510
US

V. Phone/Fax

Practice location:
  • Phone: 903-465-2438
  • Fax: 903-463-3741
Mailing address:
  • Phone: 903-465-2438
  • Fax: 903-463-3741

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: TROY ISSAC
Title or Position: MANAGING MEMBER
Credential:
Phone: 903-465-2438