Provider Demographics
NPI:1508890948
Name:ELDERCARE, LP
Entity Type:Organization
Organization Name:ELDERCARE, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:972-279-2011
Mailing Address - Street 1:6310 LBJ FREEWAY
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6401
Mailing Address - Country:US
Mailing Address - Phone:972-279-2011
Mailing Address - Fax:972-361-0050
Practice Address - Street 1:6310 LYNDON B JOHNSON FWY
Practice Address - Street 2:SUITE # 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6401
Practice Address - Country:US
Practice Address - Phone:972-279-2011
Practice Address - Fax:972-361-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0069430A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4915320001Medicare NSC