Provider Demographics
NPI:1275857930
Name:PCDI HEALTHCARE AND CONSULTANTS
Entity Type:Organization
Organization Name:PCDI HEALTHCARE AND CONSULTANTS
Other - Org Name:PCDI HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:RNA
Authorized Official - Phone:469-523-1395
Mailing Address - Street 1:610 UPTOWN BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3527
Mailing Address - Country:US
Mailing Address - Phone:469-523-1395
Mailing Address - Fax:
Practice Address - Street 1:610 UPTOWN BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3527
Practice Address - Country:US
Practice Address - Phone:469-523-1395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based