MEDICARE: LIFECARE HOSPITALS OF NORTH TEXAS LP

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	282E00000X	Long Term Care Hospital	00717	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841224060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFECARE HOSPITALS OF NORTH TEXAS LP

Provider Business Mailing Address
First Line	:	5340 LEGACY DR
Second Line	:	SUITE 150
City	:	PLANO
State	:	TX
Zip	:	75024-3178
Country	:	US
Telephone Number	:	469-241-2100
Fax Number	:	469-241-5198

Provider Business Practice Location Address
First Line	:	1950 RECORD CROSSING RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6223
Country	:	US
Telephone Number	:	214-640-9600
Fax Number	:	214-640-9654

Authorized Official
Title or Position	:	VICE PRESIDENT OF REIMBURSEMENT
Name	:	MR. MICHAEL CRONIN
Credential	:	CPA
Telephone Number	:	469-241-2128

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/14/2012

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