Provider Demographics
NPI:1316086515
Name:PILOT POINT OPERATIONS, LLC
Entity type:Organization
Organization Name:PILOT POINT OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C F O
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-303-4089
Mailing Address - Street 1:905 MEDICAL CENTRE DR STE B
Mailing Address - Street 2:SUITE B
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4792
Mailing Address - Country:US
Mailing Address - Phone:817-303-4089
Mailing Address - Fax:
Practice Address - Street 1:208 N PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-4057
Practice Address - Country:US
Practice Address - Phone:940-686-5507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675902Medicare Oscar/Certification