Premium Assisted Care

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

PREMIUM ASSISTED CARE

Practice address

549 Hillcrest Dr
Garland, TX 75040-5618

Phone

(214) 808-6070

NPI assigned

Oct 25, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Doris Mae Gordon

Title

Program Manager (Owner)

Phone

(214) 808-6070

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1811273642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 LOMA ALTA DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751503185",
            "telephone_number": "214-808-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 HILLCREST DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750405618",
            "telephone_number": "214-808-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM ASSISTED CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "PROGRAM MANAGER (OWNER)",
        "authorized_official_telephone_number": "214-808-6070",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "978967170",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Garland, TX
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.