Healthcare Provider Details

I. General information

NPI: 1659197242
Provider Name (Legal Business Name): OAK MANOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLLEGE ST
SCHULENBURG TX
78956-1601
US

IV. Provider business mailing address

111 COLLEGE ST
SCHULENBURG TX
78956-1601
US

V. Phone/Fax

Practice location:
  • Phone: 979-743-6537
  • Fax: 979-743-3485
Mailing address:
  • Phone: 979-743-6537
  • Fax: 979-743-3485

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: PEYTON MICHELLE HATFIELD
Title or Position: FACILITY ADMINISTRATOR
Credential: RN, BSN LNFA
Phone: 979-249-7527