Procore Select, LLC.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROCORE SELECT, LLC.

Practice address

17300 Dallas Pkwy Ste 1075
Dallas, TX 75248-7713

Phone

(469) 640-0849

NPI assigned

Sep 17, 2018

Organization subpart

No

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

Authorized official

Name

Keith Palmer

Title

Chief Executive Officer

Phone

(832) 721-9427

Specialties & licenses 1

Addresses

Other names 1

• Trestige Doing business as

Locations

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1689158685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 DALLAS PKWY STE 1075",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752487713",
            "telephone_number": "469-640-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 DALLAS PKWY STE 1075",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752487713",
            "telephone_number": "469-640-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCORE SELECT, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "832-721-9427"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trestige",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kimberly Lauren Prock, MD
• David Procter
• Jessica Procter, M.D.
• Brittney Proctor
• Kayla Renea Proctor
• Lara Proctor, M.S., L.P.C.

• Durable Medical Equipment & Medical Supplies in Dallas, TX
• Providers in Dallas, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.