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General NPI Number Information
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NPI Number | 1710822267
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Entity Type | Organization
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Legal Business Name | CHISHOLM TRAIL SCAL LLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 5100 RANDOL MILL RD
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City | FORT WORTH
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State | TX
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Zip | 76112-1553
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Country | US
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Telephone | 866-304-6801
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Fax | 972-300-3640
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Provider Business Mailing Address
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Address Line | 5100 RANDOL MILL RD
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City | FORT WORTH
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State | TX
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Zip | 76112-1553
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Country | US
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Telephone | 866-304-6801
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Fax | 972-300-3640
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DIAN BURNS
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Credential |
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Telephone | 866-304-6801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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