PM Management-San Angelo NC I LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

128894 Issued in TX

Legal business name

PM MANAGEMENT-SAN ANGELO NC I LLC

Doing business as

Trisun Care Center-Meadow Creek

Practice address

4343 Oak Grove Blvd
San Angelo, TX 76904-4550

Phone

(325) 949-2559

Fax

(325) 949-3598

NPI assigned

Dec 11, 2006

Last updated

Aug 31, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lew N Little Jr.

Title

Ceo

Phone

(512) 634-4900

Specialties & licenses 1

Addresses

Other names 1

• Trisun Care Center-Meadow Creek Doing business as

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1972663813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 W. FIFTH ST",
            "address_2": "SUITE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78703",
            "telephone_number": "512-634-4900",
            "fax_number": "512-634-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 OAK GROVE BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769044550",
            "telephone_number": "325-949-2559",
            "fax_number": "325-949-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT-SAN ANGELO NC I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "LEW",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-634-4900",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "128894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trisun Care Center-Meadow Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurel Ann Pittillo, PMHNP-BC
• Timothy Shaun Pittman, D.C.
• Jessica Marie Pizzola
• Stephan Gene Pizzola, MD
• Planned Parenthood of West Texas
• PM Management-San Angelo NC II LLC (Trisun Care Center Regency House)
• Srikanth Podaralla, M.D., M.B.A
• Lonnie M Pollard, DDS11/
• Amanda Leigh Pollitt, DO
• Billy Cleave Pool, LPC

• Skilled Nursing Facility in San Angelo, TX
• Providers in San Angelo, 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 Aug 31, 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.