1457739146 NPI number — BUCKNER RETIREMENT SERVICES, INC.

Table of content: (NPI 1457739146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457739146 NPI number — BUCKNER RETIREMENT SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUCKNER RETIREMENT SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457739146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12377 MERIT DR STE 900
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-758-8000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11111 KATY FREEWAY
Provider Second Line Business Practice Location Address:
SUITE 520
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77079-2116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-493-6800
Provider Business Practice Location Address Fax Number:
821-493-6807
Provider Enumeration Date:
05/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
Authorized Official Title or Position:
MGR OR ADMINISTRATION & CONTRACT
Authorized Official Telephone Number:
214-758-8136

Provider Taxonomy Codes

  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1019436 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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