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NPI Code Detail

MEDICARE: PECAN GROVE ASSISTED LIVING, LLC

MEDICARE: PECAN GROVE ASSISTED LIVING, 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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1851257992
Entity Type Code : Organization
Provider Name (Legal Business Name) : PECAN GROVE ASSISTED LIVING, LLC
Provider Business Mailing Address
First Line : 513 FM 359 RD
Second Line :
City : RICHMOND
State : TX
Zip : 77406-2001
Country : US
Telephone Number : 281-232-3214
Fax Number :
Provider Business Practice Location Address
First Line : 513 FM 359 RD
Second Line :
City : RICHMOND
State : TX
Zip : 77406-2001
Country : US
Telephone Number : 281-232-3214
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : SHENU KHAN
Credential :
Telephone Number : 713-725-4913
Provider Enumeration Date : 01/02/2026
Last Update Date : 01/02/2026

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Directions to “PECAN GROVE ASSISTED LIVING, LLC ” Practice Location

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