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NPI Code Detail

MEDICARE: ELITE MEDICAL STAFFING AGENCY

MEDICARE: ELITE MEDICAL STAFFING AGENCY
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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1508719709
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE MEDICAL STAFFING AGENCY
Provider Business Mailing Address
First Line : 613 CRESTHAVEN DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7864
Country : US
Telephone Number : 214-623-5623
Fax Number :
Provider Business Practice Location Address
First Line : 613 CRESTHAVEN DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7864
Country : US
Telephone Number : 214-623-5623
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CIERA MANGUM
Credential : COTA
Telephone Number : 214-623-5623
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ELITE MEDICAL STAFFING AGENCY ” Practice Location

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