Healthcare Provider Details

I. General information

NPI: 1649267147
Provider Name (Legal Business Name): CARRIZO SPRINGS NURSING AND REHABILITATION LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 S 7TH ST
CARRIZO SPRINGS TX
78834-3815
US

IV. Provider business mailing address

419 S ELM ST
DENTON TX
76201-6085
US

V. Phone/Fax

Practice location:
  • Phone: 830-876-5011
  • Fax: 830-876-9414
Mailing address:
  • Phone: 940-387-4388
  • Fax: 940-380-2410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. DAN D. FLAGG
Title or Position: CEO
Credential:
Phone: 940-387-4388