Provider Demographics
NPI:1457739146
Name:BUCKNER RETIREMENT SERVICES, INC.
Entity type:Organization
Organization Name:BUCKNER RETIREMENT SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR OR ADMINISTRATION & CONTRACT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-758-8136
Mailing Address - Street 1:12377 MERIT DR STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:214-758-8000
Mailing Address - Fax:
Practice Address - Street 1:11111 KATY FREEWAY
Practice Address - Street 2:SUITE 520
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2116
Practice Address - Country:US
Practice Address - Phone:281-493-6800
Practice Address - Fax:821-493-6807
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUCKNER RETIREMENT SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-13
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1019436Medicaid
TX671661Medicare PIN