MEDICARE: K & Z MANAGED CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	004619	OTHER	TX	FACILITY ID NUMBER

General Provider Information

NPI Number	:	1265570907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K & Z MANAGED CARE LLC

Provider Business Mailing Address
First Line	:	2902 BONHAM AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79762-7926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9001 N LOOP DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-4742
Country	:	US
Telephone Number	:	915-859-1650
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BETTY TURNER
Credential	:
Telephone Number	:	432-634-8149

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	08/22/2020

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