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General NPI Number Information
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NPI Number | 1093185225
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS LONG TERM CARE , P.A.
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 3105 COLORADO BLVD
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City | DENTON
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State | TX
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Zip | 76210-6893
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Country | US
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Telephone | 940-383-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 3105 COLORADO BLVD
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City | DENTON
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State | TX
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Zip | 76210-6893
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Country | US
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Telephone | 940-383-3444
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | STANLEY C EVANS
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Credential | D.O.
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Telephone | 940-383-3444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | J1993
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License Number State | TX
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