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NPI Code Detail

MEDICARE: THI OF TEXAS AT PLANO LLC

MEDICARE: THI OF TEXAS AT PLANO 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
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001012236OTHERTXCBA RESPITE ID NUMBER

General Provider Information

NPI Number : 1639305550
Entity Type Code : Organization
Provider Name (Legal Business Name) : THI OF TEXAS AT PLANO LLC
Provider Business Mailing Address
First Line : 930 RIDGEBROOK RD
Second Line :
City : SPARKS
State : MD
Zip : 21152-9390
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3208 THUNDERBIRD LN
Second Line :
City : PLANO
State : TX
Zip : 75075-2321
Country : US
Telephone Number : 972-422-2214
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOHN WILSON
Credential :
Telephone Number : 972-422-2214
Provider Enumeration Date : 06/05/2009
Last Update Date : 06/05/2009

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Directions to “THI OF TEXAS AT PLANO LLC ” Practice Location

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