Healthcare Provider Details

I. General information

NPI: 1255654133
Provider Name (Legal Business Name): SEARS TYLER METHODIST RETIREMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16044 COUNTY ROAD 165
TYLER TX
75703-7302
US

IV. Provider business mailing address

1 VILLAGE DR SUITE 400
ABILENE TX
79606-8231
US

V. Phone/Fax

Practice location:
  • Phone: 903-526-5599
  • Fax: 903-526-3717
Mailing address:
  • Phone: 328-691-5519
  • Fax: 325-698-4582

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: THERESA MERE
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 325-691-5519