MEDICARE: OAK MANOR INC

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
1	251J00000X	Nursing Care Agency	251J00000X	TX
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	332BP3500X	TX

General Provider Information

NPI Number	:	1366497828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK MANOR INC

Provider Business Mailing Address
First Line	:	111 COLLEGE
Second Line	:
City	:	SCHULENBURG
State	:	TX
Zip	:	78956
Country	:	US
Telephone Number	:	979-743-6537
Fax Number	:	979-743-6537

Provider Business Practice Location Address
First Line	:	111 COLLEGE
Second Line	:
City	:	SCHULENBURG
State	:	TX
Zip	:	78956
Country	:	US
Telephone Number	:	979-743-6537
Fax Number	:	979-743-6537

Authorized Official
Title or Position	:	OWNER
Name	:	LESLIE GRIEVE
Credential	:
Telephone Number	:	979-743-6537

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	09/11/2025

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Directions to “OAK MANOR INC ” Practice Location

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