Provider Demographics
NPI:1033405162
Name:PARK CITIES HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PARK CITIES HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:QUICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-500-9839
Mailing Address - Street 1:410 SAN JOSE ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4610
Mailing Address - Country:US
Mailing Address - Phone:214-500-9139
Mailing Address - Fax:972-570-1980
Practice Address - Street 1:410 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4610
Practice Address - Country:US
Practice Address - Phone:214-500-9139
Practice Address - Fax:972-570-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605576251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care