MEDICARE: THI OF TEXAS AT SAN ANTONIO III, 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1386731578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THI OF TEXAS AT SAN ANTONIO III, LLC

Provider Business Mailing Address
First Line	:	930 RIDGEBROOK RD
Second Line	:
City	:	SPARKS
State	:	MD
Zip	:	21152-9390
Country	:	US
Telephone Number	:	410-773-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7302 OAK MANOR DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4509
Country	:	US
Telephone Number	:	210-344-8537
Fax Number	:	210-344-4645

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS SCHUBBE
Credential	:
Telephone Number	:	210-344-8537

Provider Enumeration Date	:	10/07/2006
Last Update Date	:	04/03/2008

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