Provider Demographics
NPI:1720371412
Name:BCA TXHML
Entity Type:Organization
Organization Name:BCA TXHML
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN-SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-774-1070
Mailing Address - Street 1:PO BOX 530652
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75053-0652
Mailing Address - Country:US
Mailing Address - Phone:972-263-8223
Mailing Address - Fax:
Practice Address - Street 1:101 SW DALLAS ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1735
Practice Address - Country:US
Practice Address - Phone:972-263-8223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No302F00000XManaged Care OrganizationsExclusive Provider Organization