Healthcare Provider Details

I. General information

NPI: 1184046856
Provider Name (Legal Business Name): ROUND ROCK SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 COLLEGE PARK
ROUND ROCK TX
78665-1522
US

IV. Provider business mailing address

1500 WATERS RIDGE DR
LEWISVILLE TX
75057-6011
US

V. Phone/Fax

Practice location:
  • Phone: 512-334-8000
  • Fax: 512-334-8005
Mailing address:
  • Phone: 972-899-4401
  • Fax: 972-899-4806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: PAULA PIERCE
Title or Position: AUTHORIZED OFFICER
Credential:
Phone: 972-899-4401