Healthcare Provider Details

I. General information

NPI: 1245538354
Provider Name (Legal Business Name): SOUTHWEST LTC-PARIS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2011
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 47TH ST SE
PARIS TX
75462-7417
US

IV. Provider business mailing address

150 47TH ST SE
PARIS TX
75462-7417
US

V. Phone/Fax

Practice location:
  • Phone: 903-784-3100
  • Fax:
Mailing address:
  • Phone: 903-784-3100
  • 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: RONALD R PAYNE
Title or Position: MANAGER
Credential:
Phone: 469-916-6100