FALLEN TREE CORP (NPI# 1841467727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841467727 |
| Entity Type | Organization |
| Organization Name | FALLEN TREE CORP |
| Practice Address |
11416 Runnel Ridge Rd Manor TX 78653-3874 |
| Practice Telephone | 5127600666 |
| Practice Fax Number | 8662651725 |
| Mailing Telephone | 5127600666 |
| Mailing Fax Number | 8662651725 |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2019-06-22 |
| Authorized Official Name | DR. PEYTON THOMPSON (OWNER, PRESIDENT) |
| Authorized Official Telephone | 5127600666 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | DD9687 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | DD9687 | TX | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | D9687 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 197360401 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 812 N Crockett Ave, Cameron, TX 765202553 | 5125222299 | 5123675997 |
| Street Address |
11416 RUNNEL RIDGE RD |
| City | MANOR |
| State | TX |
| Zip Code | 78653-3874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861439069 | Peyton Thompson | Family Medicine | 11416 Runnel Ridge Rd, Manor, TX 78653-3874 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588293112 | Angelica Marie Griffin | Residential Treatment Facility, Emotionally Disturbed Children | 12500 Shadowglen Trace 3204, Manor, TX 78653 | 2020-04-06 |
| 1215591391 | Manor Total Dental and Orthodontics Pllc | Durable Medical Equipment & Medical Supplies | 11828 Ring Dr. Ste 102, Manor, TX 78653 | 2019-04-24 |
| 1932698412 | New Hope Ranch | Substance Abuse Rehabilitation Facility | 11908 Sparks Road, Manor, TX 78653 | 2018-05-09 |
| 1649788332 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 12700 Lexington Street, Suite 220, Manor, TX 78653 | 2018-01-16 |
| 1760998934 | Open Hearts & Open Doors Group Home Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11605 Mill Ridge Trce, Manor, TX 78653 | 2017-12-22 |
| 1184089443 | Manor Family Orthodontics, Pllc | Dentist | 11828 Ring Dr, Ste 102, Manor, TX 78653 | 2015-12-30 |
| 1225424542 | Rsvp Healthcare Alliance, LLC | Pharmacy | 14008 Shadow Glen Blvd, Ste 102, Manor, TX 78653 | 2015-04-14 |
| 1023410560 | Demitra Stephens Haynes | In Home Supportive Care | 18116 Flathead Dr, Manor, TX 78653 | 2014-09-16 |
| 1922429836 | Wal-mart Stores Texas LLC | Technician/Technologist | 11923 Us Hwy 290 E, Manor, TX 78653 | 2013-12-18 |
| 1710326434 | Lizania Montero | Dentist | 11300 Hwy 290 E, Suite 200, Manor, TX 78653 | 2013-06-15 |
| Find all providers in zip 78653 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.