Provider Demographics
NPI:1568029023
Name:BCS MANAGEMENT LLC
Entity Type:Organization
Organization Name:BCS MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:FONDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-517-1219
Mailing Address - Street 1:2642 N BELT LINE RD
Mailing Address - Street 2:SUITE 2642
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:305-570-1666
Mailing Address - Fax:305-203-0546
Practice Address - Street 1:2642 N BELT LINE RD
Practice Address - Street 2:SUITE 2642
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062
Practice Address - Country:US
Practice Address - Phone:305-570-1666
Practice Address - Fax:305-203-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1283273OtherMEDICAL LICENSE