Healthcare Provider Details

I. General information

NPI: 1972677540
Provider Name (Legal Business Name): GERIATRIC CARE OF TEXAS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 1/2 E HOSPITAL DR
ANGLETON TX
77515-4111
US

IV. Provider business mailing address

135 1/2 E HOSPITAL DR
ANGLETON TX
77515-4111
US

V. Phone/Fax

Practice location:
  • Phone: 979-849-8221
  • Fax: 979-849-1941
Mailing address:
  • Phone: 979-849-8221
  • Fax: 979-849-1941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number114686
License Number StateTX

VIII. Authorized Official

Name: MRS. VELDA PHELPS-WASSON
Title or Position: ADMINISTRATOR
Credential: LNFA
Phone: 979-849-8221