Provider Demographics
NPI:1487372348
Name:SILVERLINE PARTNERS OF TEXAS LLC
Entity type:Organization
Organization Name:SILVERLINE PARTNERS OF TEXAS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-547-2222
Mailing Address - Street 1:3232 GREAT TRINITY FOREST WAY # 103
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7732
Mailing Address - Country:US
Mailing Address - Phone:469-547-2222
Mailing Address - Fax:469-547-2220
Practice Address - Street 1:3232 GREAT TRINITY FOREST WAY # 103
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7732
Practice Address - Country:US
Practice Address - Phone:469-547-2222
Practice Address - Fax:469-547-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149797Medicaid