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General NPI Number Information
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NPI Number | 1558357327
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Entity Type | Organization
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Legal Business Name | PALO DURO NURSING AND REHABILITATION
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1931 MEDI PARK DR
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City | AMARILLO
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State | TX
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Zip | 79106-2182
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Country | US
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Telephone | 806-352-5600
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Fax | 806-352-6071
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Provider Business Mailing Address
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Address Line | 401 N ELM ST
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City | DENTON
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State | TX
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Zip | 76201-4137
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Country | US
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Telephone | 940-387-4388
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Fax | 940-380-2410
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DAVID L BYERS
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Credential |
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Telephone | 940-387-4388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 109559
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License Number State | TX
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