Provider Demographics
NPI: | 1093541310 |
---|---|
Name: | NOVA TRANSITIONAL CARE, PLLC |
Entity type: | Organization |
Organization Name: | NOVA TRANSITIONAL CARE, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DERRICK |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROBERSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-660-6271 |
Mailing Address - Street 1: | 6010 WARREN PKWY |
Mailing Address - Street 2: | SUITE 100 |
Mailing Address - City: | FRISCO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75034 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-660-6271 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6010 WARREN PKWY |
Practice Address - Street 2: | SUITE 100 |
Practice Address - City: | FRISCO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75034 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-660-6271 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-09-12 |
Last Update Date: | 2024-09-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care | Group - Multi-Specialty |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 207QA0505X | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | Group - Multi-Specialty |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 2081P2900X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | Group - Multi-Specialty |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | Group - Multi-Specialty |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |