CHG Senior Living Preston Hollow, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CHG SENIOR LIVING PRESTON HOLLOW, LLC

Doing business as

Crystal Creek at Preston Hollow

Practice address

11409 N Central Expy
Dallas, TX 75243-6678

Phone

(214) 363-5100

Fax

(214) 363-5133

NPI assigned

Apr 5, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kurt J. Schultz

Title

Cfo

Phone

(469) 621-6700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CRYSTAL CREEK AT PRESTON HOLLOW Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1063876118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ROSS AVE",
            "address_2": "SUITE 5400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012708",
            "telephone_number": "469-621-6700",
            "fax_number": "469-621-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11409 N CENTRAL EXPY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436678",
            "telephone_number": "214-363-5100",
            "fax_number": "214-363-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHG SENIOR LIVING PRESTON HOLLOW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "469-621-6700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001027726",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRYSTAL CREEK AT PRESTON HOLLOW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Quentin James Chevalier, PHARMD.
• Faria Chevez, DNP, APRN, FNP-C
• Ee Ming Darryl Chew, MBBS
• Ivan Nicholas Chew, MD
• Susan M. Chew, CNM
• Avneesh Chhabra, M.D.
• Samir Amit Chhaya, MD
• Sheila Chhutani, M.D.
• Lei CHI, M.D.
• Monica Han-Yan Lui CHI, PHARMD

• Skilled Nursing Facility in Dallas, TX
• Providers in Dallas, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.