1861486599 NPI number — HMG LEWISVILLE SNF OPERATIONS, LP

Table of content: (NPI 1861486599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861486599 NPI number — HMG LEWISVILLE SNF OPERATIONS, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HMG LEWISVILLE SNF OPERATIONS, LP
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:
1861486599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 WATERS RIDGE DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LEWISVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75057-6011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-899-4401
Provider Business Mailing Address Fax Number:
972-899-4460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 E VISTA RIDGE MALL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75067-8339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-906-9789
Provider Business Practice Location Address Fax Number:
972-956-9491
Provider Enumeration Date:
09/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PIERCE
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICER
Authorized Official Telephone Number:
972-899-4401

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  115351 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com