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NPI Code Detail

MEDICARE: WICHITA FALLS OPERATING COMPANY LLC

MEDICARE: WICHITA FALLS OPERATING COMPANY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1275962870
Entity Type Code : Organization
Provider Name (Legal Business Name) : WICHITA FALLS OPERATING COMPANY LLC
Provider Business Mailing Address
First Line : 1101 GRACE ST
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76301-4414
Country : US
Telephone Number : 940-322-3393
Fax Number :
Provider Business Practice Location Address
First Line : 5300 W SAM HOUSTON PKWY N
Second Line : SUITE 100
City : HOUSTON
State : TX
Zip : 77041-5161
Country : US
Telephone Number : 832-467-6000
Fax Number :
Authorized Official
Title or Position : SVP OPERATIONS FINANCE
Name : THOMAS P SIMONS
Credential :
Telephone Number : 678-443-7000
Provider Enumeration Date : 11/04/2013
Last Update Date : 11/04/2013

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Directions to “WICHITA FALLS OPERATING COMPANY LLC ” Practice Location

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