Provider Demographics
NPI:1982165734
Name:FPACP WEBSTER LLC
Entity Type:Organization
Organization Name:FPACP WEBSTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKETT
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 1:17231 MILL FOREST RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4308
Practice Address - Country:US
Practice Address - Phone:281-488-5224
Practice Address - Fax:281-461-8576
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOCUSED POST ACUTE CARE PARTNERS MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility