Provider Demographics
NPI:1215090428
Name:PINNACLE HEALTH FACILITIES OF TEXAS XI, L.P.
Entity type:Organization
Organization Name:PINNACLE HEALTH FACILITIES OF TEXAS XI, L.P.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LATTURE
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-930-8122
Mailing Address - Street 1:5420 W PLANO PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4823
Mailing Address - Country:US
Mailing Address - Phone:972-930-8122
Mailing Address - Fax:972-930-8191
Practice Address - Street 1:4195 MILAM ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-3918
Practice Address - Country:US
Practice Address - Phone:409-842-4550
Practice Address - Fax:409-840-2052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE HEALTH FACILITITES OF TEXAS XI, L.P.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-18
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014125Medicaid