Healthcare Provider Details

I. General information

NPI: 1891330494
Provider Name (Legal Business Name): CARADAY TRINITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MAIN ST
ROUND ROCK TX
78664-4442
US

IV. Provider business mailing address

1000 E MAIN ST
ROUND ROCK TX
78664-4442
US

V. Phone/Fax

Practice location:
  • Phone: 512-634-3000
  • Fax: 512-634-3074
Mailing address:
  • Phone: 512-634-3000
  • Fax: 512-634-3074

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: GREG MOORE
Title or Position: AUTHORIZED OFFICER
Credential:
Phone: 512-634-3000