Provider Demographics
NPI:1013219617
Name:DFW PIONEER ADC
Entity type:Organization
Organization Name:DFW PIONEER ADC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYLE
Authorized Official - Middle Name:X
Authorized Official - Last Name:MATTHIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-837-6950
Mailing Address - Street 1:3200 SAN PAULA CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012
Mailing Address - Country:US
Mailing Address - Phone:214-837-6950
Mailing Address - Fax:817-459-3314
Practice Address - Street 1:1115 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-7624
Practice Address - Country:US
Practice Address - Phone:817-459-3311
Practice Address - Fax:817-459-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No333300000XSuppliersEmergency Response System Companies
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle