Healthcare Provider Details

I. General information

NPI: 1922040468
Provider Name (Legal Business Name): PHCC-PARAMOUNT REHABILITATION AND HEALTH CARE CENTER SAN ANTONIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5437 EISENHAUER RD
SAN ANTONIO TX
78218-3757
US

IV. Provider business mailing address

5437 EISENHAUER RD
SAN ANTONIO TX
78218-3757
US

V. Phone/Fax

Practice location:
  • Phone: 210-646-9576
  • Fax: 210-653-3695
Mailing address:
  • Phone: 210-646-9576
  • Fax: 210-653-3695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100297
License Number StateTX

VIII. Authorized Official

Name: MR. JAMES ARTHUR MEYERS JR.
Title or Position: PRESIDENT, CFO
Credential:
Phone: 210-545-6320