Healthcare Provider Details

I. General information

NPI: 1891860235
Provider Name (Legal Business Name): PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 S LOOP 256
PALESTINE TX
75801-8467
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-5098
US

V. Phone/Fax

Practice location:
  • Phone: 903-731-1000
  • Fax: 903-731-2236
Mailing address:
  • Phone: 615-920-7000
  • Fax: 615-920-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KATHY J. TEAGUE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000