Provider Demographics
| NPI: | 1053691816 |
|---|---|
| Name: | PILLANS HEALTHCARE |
| Entity type: | Organization |
| Organization Name: | PILLANS HEALTHCARE |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | MEMBER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | WILLIAM |
| Authorized Official - Middle Name: | P |
| Authorized Official - Last Name: | PILLANS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 214-244-4694 |
| Mailing Address - Street 1: | 322 LINCOLN DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | STREETMAN |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75859-3287 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 903-389-5986 |
| Mailing Address - Fax: | 903-389-6749 |
| Practice Address - Street 1: | 716 MIMOSA DR |
| Practice Address - Street 2: | |
| Practice Address - City: | MINEOLA |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75773-2612 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 903-569-5366 |
| Practice Address - Fax: | 903-569-9050 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2011-08-25 |
| Last Update Date: | 2011-08-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 675981 | Medicare Oscar/Certification |