National Nursing & Rehab Dallas, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

016730 Issued in TX

Legal business name

NATIONAL NURSING & REHAB DALLAS, LLC

Practice address

14114 Dallas Pkwy
Suite 670
Dallas, TX 75254-4325

Phone

(972) 716-9937

Fax

(972) 716-9961

NPI assigned

Sep 9, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Steven D Wallace

Title

Owner / Ceo

Phone

(210) 822-2654

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1417358474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 NE LOOP 410",
            "address_2": "SUITE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165866",
            "telephone_number": "210-822-0475",
            "fax_number": "210-822-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14114 DALLAS PKWY",
            "address_2": "SUITE 670",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752544325",
            "telephone_number": "972-716-9937",
            "fax_number": "972-716-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL NURSING & REHAB DALLAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "210-822-2654",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "016730",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "TX",
            "license": "016730",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": "016730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357625801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.