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NPI Code Detail

MEDICARE: HMG PARK MANOR OF FRIENDSWOOD, LLC

MEDICARE: HMG PARK MANOR OF FRIENDSWOOD, 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 : 1487078168
Entity Type Code : Organization
Provider Name (Legal Business Name) : HMG PARK MANOR OF FRIENDSWOOD, LLC
Provider Business Mailing Address
First Line : 4 WATERWAY SQUARE PLACE
Second Line : SUITE 350
City : THE WOODLANDS
State : TX
Zip : 77380-2695
Country : US
Telephone Number : 281-419-5520
Fax Number : 281-419-5527
Provider Business Practice Location Address
First Line : 1500 SUNSET DR
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4724
Country : US
Telephone Number : 281-992-4300
Fax Number : 281-992-0964
Authorized Official
Title or Position : EXECUTIVE ASSISTANT
Name : NITA RENEAU
Credential :
Telephone Number : 281-419-5520
Provider Enumeration Date : 02/14/2014
Last Update Date : 02/14/2014

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Directions to “HMG PARK MANOR OF FRIENDSWOOD, LLC ” Practice Location

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