Healthcare Provider Details

I. General information

NPI: 1871890970
Provider Name (Legal Business Name): MCGREGOR SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 JOHNSON DR
MC GREGOR TX
76657-1426
US

IV. Provider business mailing address

200 W. HWY 6 SUITE # 612
WACO TX
76712
US

V. Phone/Fax

Practice location:
  • Phone: 254-840-3281
  • Fax:
Mailing address:
  • Phone: 254-399-6788
  • Fax: 254-399-6766

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: MICHAEL BUMPASS
Title or Position: MEMBER
Credential:
Phone: 254-399-6788