NPIMap

Organization Active NPI

Fannin County Hospital Authority

  • Skilled Nursing Facility
  • Allen, TX
National Provider Identifier
1124884481
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FANNIN COUNTY HOSPITAL AUTHORITY
Practice address
310 S Jupiter Rd
Allen, TX 75002-3039
Phone
(972) 727-5850
Fax
(972) 727-5625
NPI assigned
Feb 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Authorized official

Name
Clark Sanderson
Title
Board President
Phone
(817) 372-7224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

310 S Jupiter Rd
Allen, TX 75002-3039

Mailing address

310 S Jupiter Rd
Allen, TX 75002-3039
Phone (972) 727-5850

Other names 1

  • Victoria Gardens of Allen Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240531002536 TX Part A Provider - Skilled Nursing Facility 9931541208 Practice locations: Allen, TX

Skilled nursing facility certification: CCN 675882

Legal name
PMG OPCO-ALLEN LLC
Doing business as
VICTORIA GARDENS OF ALLEN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 15, 2001
Last certification
Nov 20, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
310 S Jupiter Rd
Allen, TX 75002-3039
Nursing home name
VICTORIA GARDENS OF ALLEN
Affiliated entity
PRIORITY MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Victoria Gardens of AllenCCN 675882
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 15, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12087.2 residents per day on average
Chain
Priority Management38 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Douglas B Boulware Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 12.5%
Adp of the SNF Apr 1, 2024
Katie B Walker Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 25%
Adp of the SNF Apr 1, 2024
Thomas C Boulware Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 25%
Adp of the SNF Apr 1, 2024
MD Jewel Ahmed Individual Operational/Managerial Control Sep 6, 2021
Adp of the SNF Sep 6, 2021
Steven Boulware Family Investments LLC Organization, Dallas, TX LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2024 33.33%
Adp of the SNF Apr 1, 2024
John Dohlman Individual Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Bridgepointe Finanical Services, LLC Organization, Dallas, TX LLC Operational/Managerial Control Apr 1, 2024
Adp of the SNF Jun 17, 2025
Priority Management Group, LLC Organization, Dallas, TX LLC Operational/Managerial Control Apr 1, 2024
Adp of the SNF May 20, 2025
Sandra Boulware Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 12.5%
Adp of the SNF Apr 1, 2024
Steven D Boulware Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 25%
Adp of the SNF Apr 1, 2024
Parker C Bauder Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 25%
Adp of the SNF Apr 1, 2025
Boulware St James LLC Organization, Dallas, TX LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2024 33.34%
Adp of the SNF Apr 1, 2024
Innovative Nurse Consulting, LLC Organization, Dallas, TX LLC Operational/Managerial Control Apr 1, 2024
Adp of the SNF Jun 17, 2025
PMG Realco - Allen, LLC Organization, Dallas, TX LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Apr 1, 2024 100%
Adp of the SNF Apr 1, 2024
Kelly P Bauder Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 25%
Adp of the SNF Apr 1, 2024
Progressive Rehab Solutions, LLC Organization, Dallas, TX LLC Operational/Managerial Control Apr 1, 2024
Adp of the SNF Jun 17, 2025
Madison R Bauder Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 25%
Adp of the SNF Apr 1, 2025
Bobbie Miller Individual Adp of the SNF Apr 1, 2024
William M Bauder Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 25%
Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Bauder Family Investments, LLC Organization, Dallas, TX LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2024 33.33%
Adp of the SNF Apr 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 23

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 23

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1124884481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S JUPITER RD",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023039",
            "telephone_number": "972-727-5850",
            "fax_number": "972-727-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S JUPITER RD",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023039",
            "telephone_number": "972-727-5850",
            "fax_number": "972-727-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANNIN COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "SANDERSON",
        "authorized_official_first_name": "CLARK",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "817-372-7224"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victoria Gardens of Allen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.