Provider Demographics
NPI:1790422822
Name:PH OPS OF DALLAS LLC
Entity Type:Organization
Organization Name:PH OPS OF DALLAS LLC
Other - Org Name:PURE HEALTH TRANSITIONAL CARE AT TEXAS HEALTH PRESBYTERIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SIOBAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:565-801-4235
Mailing Address - Street 1:784 US HIGHWAY 1 STE 22
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4411
Mailing Address - Country:US
Mailing Address - Phone:561-801-4235
Mailing Address - Fax:
Practice Address - Street 1:8200 WALNUT HILL LN # 5
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4402
Practice Address - Country:US
Practice Address - Phone:214-345-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility