Healthcare Provider Details

I. General information

NPI: 1073501771
Provider Name (Legal Business Name): BROWNWOOD OPERATIONS I. LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SONG BIRD CIRCLE
BROWNWOOD TX
76801-6488
US

IV. Provider business mailing address

2500 SONG BIRD CIRCLE
BROWNWOOD TX
76801-6488
US

V. Phone/Fax

Practice location:
  • Phone: 325-646-4750
  • Fax: 325-646-5697
Mailing address:
  • Phone: 325-646-4750
  • Fax: 325-646-5697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number109612
License Number StateTX

VIII. Authorized Official

Name: MR. SHAWN LEON CONLEY
Title or Position: CFO
Credential: CFO
Phone: 817-303-4089