Pecan Tree SCC, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PECAN TREE SCC, LLC

Practice address

1900 E California St
Gainesville, TX 76240-4400

Phone

(940) 668-6263

Fax

(940) 668-0189

NPI assigned

May 25, 2010

Organization subpart

No

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

Authorized official

Name

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pecan Tree Rehab and Healthcare Center Doing business as

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1649599002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E CALIFORNIA ST",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762404400",
            "telephone_number": "940-668-6263",
            "fax_number": "940-668-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN TREE SCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001018601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pecan Tree Rehab and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pecan Tree Rehab and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Kwan M D P a
• Amy Sue Patrick-Ott, LPCS
• Shannon L Patrick, MSCCCSLP
• Peak Physical Therapy, LLC
• Pecan Creek Emergency Physicians PLLC
• Rita Sue Pels Bayer, P.T.
• Connor John Pelzel, PHARM D
• Ronda L Perry
• Amanda Dawn Peters, NP
• David Manh Pham, PTA

• Skilled Nursing Facility in Gainesville, TX
• Providers in Gainesville, 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 Mar 3, 2020; 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.