S TCG Benbrook Al, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

S TCG BENBROOK AL, LLC

Practice address

4242 Bryant Irvin Rd
Benbrook, TX 76109-4222

Phone

(817) 763-0088

NPI assigned

Aug 31, 2017

Organization subpart

No

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

Authorized official

Name

Michael Hall

Title

President

Phone

(214) 616-5001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1295253052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 CHERRY ST STE 2400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761026824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 BRYANT IRVIN RD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761094222",
            "telephone_number": "817-763-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S TCG BENBROOK AL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-616-5001"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javier Rosas
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• Renae Sabater, RBT
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• Rubia Sadiq, M.D
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• Perminder Sagoo, RPH

• Assisted Living Facility in Benbrook, TX
• Providers in Benbrook, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.