Healthcare Provider Details

I. General information

NPI: 1932160769
Provider Name (Legal Business Name): DUAL D HEALTH CARE OPERATIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 S ELM ST
KEMP TX
75143-7713
US

IV. Provider business mailing address

1415 BALLINGER ST
FORT WORTH TX
76102-5905
US

V. Phone/Fax

Practice location:
  • Phone: 903-498-8073
  • Fax: 903-498-8175
Mailing address:
  • Phone: 817-332-3030
  • Fax: 817-332-3032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4924
License Number StateTX

VIII. Authorized Official

Name: SHAWN CONLEY
Title or Position: C F O
Credential:
Phone: 817-332-3030