Double Creek Assisted Living LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

107007 Issued in TX

Legal business name

DOUBLE CREEK ASSISTED LIVING LP

Practice address

3200 Louis Henna Blvd.
Round Rock, TX 78664

Phone

(817) 386-8888

NPI assigned

Dec 11, 2017

Organization subpart

No

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

Authorized official

Name

Sam Kumar

Title

Managing Member

Phone

(817) 386-8888

Specialties & licenses 1

Addresses

Other names 1

• Double Creek Assisted Living and Memory Care Doing business as

Locations

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1407361561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 MAIN ST STE 2300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761025304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 LOUIS HENNA BLVD.",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "817-386-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUBLE CREEK ASSISTED LIVING LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-386-8888"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "107007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Double Creek Assisted Living and Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Dorsey, MS, LPC-S
• Lindsey J Doss, LPC
• Amena Dossul, M.D
• Andrea Felicia Dotson, CERTIFICATION
• Darrin H Dotson, O.D.
• Kenedi Paige Doucet
• Doug Carlson Builder LLC
• Erin Dougher, D.O.
• Jaime Louise Dougherty, MSN, APRN, FNP-BC
• Austin Douglas I, LAT

• Assisted Living Facility in Round Rock, TX
• Providers in Round Rock, 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 Dec 11, 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.