MEDICARE: TELESIS/TRAYMORE

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	108673	TX

General Provider Information

NPI Number	:	1710945316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELESIS/TRAYMORE

Provider Business Mailing Address
First Line	:	7602 CULCOURT ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209-3025
Country	:	US
Telephone Number	:	214-358-3131
Fax Number	:	214-358-0846

Provider Business Practice Location Address
First Line	:	7602 CULCOURT ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75209-3025
Country	:	US
Telephone Number	:	214-358-3131
Fax Number	:	214-358-0846

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. KATHLEEN M PHAIRIS
Credential	:
Telephone Number	:	214-358-3131

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/22/2020

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Directions to “TELESIS/TRAYMORE ” Practice Location

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