Provider Demographics
NPI:1568899607
Name:FCN OF TEXAS, INC.
Entity Type:Organization
Organization Name:FCN OF TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEMETRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-774-3053
Mailing Address - Street 1:1229 E PLEASANT RUN RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4209
Mailing Address - Country:US
Mailing Address - Phone:469-774-3053
Mailing Address - Fax:
Practice Address - Street 1:1229 E PLEASANT RUN RD
Practice Address - Street 2:SUITE 124
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4209
Practice Address - Country:US
Practice Address - Phone:469-774-3053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310400000X, 310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness