Healthcare Provider Details

I. General information

NPI: 1962554113
Provider Name (Legal Business Name): PILOT POINT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N PRAIRIE ST
PILOT POINT TX
76258
US

IV. Provider business mailing address

905 B MEDICAL CENTRE DR
ARLINGTON TX
76012
US

V. Phone/Fax

Practice location:
  • Phone: 940-686-5507
  • Fax: 940-686-0401
Mailing address:
  • Phone: 817-303-4089
  • Fax: 817-303-4692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SHAWN L CONLEY
Title or Position: CFO
Credential:
Phone: 817-303-4089