Healthcare Provider Details

I. General information

NPI: 1063571552
Provider Name (Legal Business Name): BUCKNER RETIREMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HORSESHOE LN
LONGVIEW TX
75605-5650
US

IV. Provider business mailing address

12377 MERIT DR STE 900
DALLAS TX
75251-3102
US

V. Phone/Fax

Practice location:
  • Phone: 903-234-0000
  • Fax: 903-757-8949
Mailing address:
  • Phone: 214-758-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number103186
License Number StateTX

VIII. Authorized Official

Name: JESSICA MOORE
Title or Position: MGR. OF ADMINISTRATION & CONTRACTS
Credential:
Phone: 214-758-8136