Healthcare Provider Details

I. General information

NPI: 1497106272
Provider Name (Legal Business Name): THE RIO AT CONROE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SOUTH CONROE MEDICAL DRIVE
CONROE TX
77304
US

IV. Provider business mailing address

8502 HUEBNER RD
SAN ANTONIO TX
78240-2465
US

V. Phone/Fax

Practice location:
  • Phone: 505-369-0113
  • Fax:
Mailing address:
  • Phone: 210-504-4309
  • Fax:

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: KURT DULLNIG
Title or Position: VP OPERATIONS
Credential:
Phone: 210-504-4309