Healthcare Provider Details

I. General information

NPI: 1184462566
Provider Name (Legal Business Name): BKD HOMEWOOD CORPUS CHRISTI PROPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 MEADOWVISTA DR
CORPUS CHRISTI TX
78414-2652
US

IV. Provider business mailing address

6410 MEADOWVISTA DR
CORPUS CHRISTI TX
78414-2652
US

V. Phone/Fax

Practice location:
  • Phone: 361-985-0555
  • Fax:
Mailing address:
  • Phone: 361-985-0555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ANNA MUNOZ
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 615-221-2250