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General NPI Number Information
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NPI Number | 1982417077
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Entity Type | Organization
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Legal Business Name | PIONEER COMPREHENSIVE CARE INC.
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 736 HALLELUJAH TRL
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City | KELLER
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State | TX
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Zip | 76248-4203
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Country | US
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Telephone | 817-973-5331
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Fax | 817-769-9140
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Provider Business Mailing Address
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Address Line | 1540 KELLER PKWY STE 108-112
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City | KELLER
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State | TX
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Zip | 76248-4601
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Country | US
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Telephone | 817-973-5331
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Fax | 817-769-9140
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MARYLYN MARIE HILLIARD
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Credential |
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Telephone | 817-973-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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