Provider Demographics
NPI:1023052263
Name:NURSING CARE OF TEXAS
Entity type:Organization
Organization Name:NURSING CARE OF TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAPTAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-296-2755
Mailing Address - Street 1:700 S COCKRELL HILL RD
Mailing Address - Street 2:166
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-2600
Mailing Address - Country:US
Mailing Address - Phone:972-296-2755
Mailing Address - Fax:972-709-8964
Practice Address - Street 1:700 S. COCKRELL HILL
Practice Address - Street 2:166
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-7705
Practice Address - Country:US
Practice Address - Phone:972-296-2755
Practice Address - Fax:972-709-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009585251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60R9391Medicaid
TX457968Medicare ID - Type Unspecified