Healthcare Provider Details
I. General information
NPI: 1639176175
Provider Name (Legal Business Name): TEXAN NURSING & REHAB OF AMARILLO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2005
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4033 W 51ST AVE
AMARILLO TX
79109-6129
US
IV. Provider business mailing address
1919 OAKWELL FARMS PKWY SUITE 255
SAN ANTONIO TX
78218-1777
US
V. Phone/Fax
- Phone: 806-355-4488
- Fax: 806-353-0885
- Phone: 210-572-0701
- Fax: 210-572-1422
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 111068 |
| License Number State | TX |
VIII. Authorized Official
Name:
JEFF
REEH
Title or Position: VICE PRESIDENT
Credential:
Phone: 210-572-0701