Provider Demographics
NPI:1356396279
Name:BUCKINGHAM SENIOR LIVING COMMUNITY INC
Entity type:Organization
Organization Name:BUCKINGHAM SENIOR LIVING COMMUNITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-413-1448
Mailing Address - Street 1:8580 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2423
Mailing Address - Country:US
Mailing Address - Phone:713-979-3100
Mailing Address - Fax:
Practice Address - Street 1:8530 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2423
Practice Address - Country:US
Practice Address - Phone:713-979-3777
Practice Address - Fax:713-979-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116910314000000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102407OtherTDADS FACILITY ID
TX102407OtherTDADS FACILITY ID