Basic Information
| Provider Information | |||||||||
| NPI: | 1679034425 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FPACP HOUSTON LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FOCUSED CARE AT WESTWOOD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 PARKVIEW DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761025841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176321000 | ||||||||
| FaxNumber: | 8176321001 | ||||||||
| Practice Location | |||||||||
| Address1: | 8702 S COURSE DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770992773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814985796 | ||||||||
| FaxNumber: | 2814985726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2019 | ||||||||
| LastUpdateDate: | 04/17/2019 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | PICKETT | ||||||||
| AuthorizedOfficialFirstName: | JAIMIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 8176321000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FOCUSED POST ACUTE CARE PARTNERS MANAGEMENT LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.