PM Management-Temple NC IV LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

124554 Issued in TX

Legal business name

PM MANAGEMENT-TEMPLE NC IV LLC

Doing business as

Temple Living Center East

Practice address

1511 Marlandwood Rd
Temple, TX 76502-3338

Phone

(254) 899-6500

Fax

(254) 899-6599

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Lew N Little Jr.

Title

Ceo

Phone

(512) 634-4900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Temple Living Center East Doing business as

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1366502213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 W. FIFTH ST",
            "address_2": "SUITE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78703",
            "telephone_number": "512-634-4900",
            "fax_number": "512-634-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 MARLANDWOOD RD",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765023338",
            "telephone_number": "254-899-6500",
            "fax_number": "254-899-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT-TEMPLE NC IV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "LEW",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-634-4900",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "124554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004737",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID NO.",
            "identifier": "005132",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Living Center East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taras Ploskanych, M.D.
• Chase Jeffry Plowman, MD
• PM Management-Temple NC I LLC
• PM Management-Temple NC II LLC
• PM Management-Temple NC III LLC
• Kelsey R Pohler, MD
• Taylor Pohler, M.D.
• Suma Pokala, M.D.
• Venkata Ratnam Polavarapu, M.D.
• Barbara L. Pollock, M.D.

• Skilled Nursing Facility in Temple, TX
• Providers in Temple, 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 Aug 28, 2009; 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.