Pecan Grove Healthcare

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

517664 Issued in TX

Legal business name

PECAN GROVE HEALTHCARE

Practice address

805 W Lampasas St
Ennis, TX 75119-4535

Phone

(972) 875-9494

Fax

(972) 878-0689

NPI assigned

Dec 7, 2011

Organization subpart

No

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

Authorized official

Name

Rebecca L Lucas, DNP,RN,FNPC

Title

Owner

Phone

(972) 875-9494

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1306114277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W LAMPASAS ST",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751194535",
            "telephone_number": "972-875-9494",
            "fax_number": "972-878-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W LAMPASAS ST",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751194535",
            "telephone_number": "972-875-9494",
            "fax_number": "972-878-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN GROVE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-875-9494",
        "authorized_official_credential": "DNP,RN,FNPC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "517664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oluchi Ozumba, MD
• Martha Xiomara Pamphile, DDS
• Aastha Parikh, DDS
• Nandish D Patel, APN
• Peak Physical Therapy and Rehabilitation LLC
• Davey M Perrin, MD
• Kristen Elizabeth Persilver
• Ruthie A Pfueller, PTA
• Tracy Tram Pham
• Kristen S Pike, LPC

• Family Nurse Practitioner in Ennis, TX
• Providers in Ennis, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.