Healthcare Provider Details

I. General information

NPI: 1760850580
Provider Name (Legal Business Name): VILLAGE OF MEYERLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 WOODWAY DR STE 410
HOUSTON TX
77057-1713
US

IV. Provider business mailing address

4141 N BRAESWOOD BLVD
HOUSTON TX
77025-2900
US

V. Phone/Fax

Practice location:
  • Phone: 281-996-0101
  • Fax: 281-996-1141
Mailing address:
  • Phone: 281-996-0101
  • Fax: 281-996-1141

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: JAMES D. GRAY
Title or Position: MANAGER
Credential:
Phone: 281-996-0101