Provider Demographics
NPI:1952827172
Name:FPACP FORT STOCKTON LLC
Entity Type:Organization
Organization Name:FPACP FORT STOCKTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-632-1000
Mailing Address - Street 1:2501 PARKVIEW DR STE 110
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-5841
Mailing Address - Country:US
Mailing Address - Phone:817-632-1000
Mailing Address - Fax:817-632-1001
Practice Address - Street 1:501 N SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735-4602
Practice Address - Country:US
Practice Address - Phone:432-336-7631
Practice Address - Fax:432-336-8870
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOCUSED POST ACUTE CARE PARTNERS II, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility