Healthcare Provider Details

I. General information

NPI: 1275576894
Provider Name (Legal Business Name): LIVING CENTERS OF TEXAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W SAM HOUSTON PKWY N
HOUSTON TX
77041-5161
US

IV. Provider business mailing address

5300 W SAM HOUSTON PKWY N
HOUSTON TX
77041-5161
US

V. Phone/Fax

Practice location:
  • Phone: 832-467-6000
  • Fax:
Mailing address:
  • Phone: 832-467-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number004305
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number11618
License Number StateTX

VIII. Authorized Official

Name: DEVIN M EHRLICH
Title or Position: EVP, GENERAL COUNSEL
Credential:
Phone: 678-443-6772