MSPF-IV Grapevine Oe, LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

117706 Issued in TX

Legal business name

MSPF-IV GRAPEVINE OE, LP

Practice address

1005 Ira E Woods Ave
Grapevine, TX 76051-4018

Phone

(817) 796-4621

Fax

(817) 796-4629

NPI assigned

Mar 13, 2008

Organization subpart

No

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

Authorized official

Name

Mr. David Ronck

Title

Manager

Phone

(214) 651-4050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lone Star Comprehensive Adult Care Doing business as

Locations

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1992976351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 TURTLE CREEK BLVD",
            "address_2": "SUITE #1850",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194402",
            "telephone_number": "214-651-4050",
            "fax_number": "214-651-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 IRA E WOODS AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514018",
            "telephone_number": "817-796-4621",
            "fax_number": "817-796-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSPF-IV GRAPEVINE OE, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "RONCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-651-4050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "117706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID VENDOR",
            "identifier": "5471",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Comprehensive Adult Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Grapevine, TX
• Providers in Grapevine, 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 Apr 7, 2008; 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.