Healthcare Provider Details

I. General information

NPI: 1770949455
Provider Name (Legal Business Name): OAKBEND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S MAIN ST
VIDOR TX
77662-5745
US

IV. Provider business mailing address

1705 JACKSON ST
RICHMOND TX
77469-3246
US

V. Phone/Fax

Practice location:
  • Phone: 409-769-3692
  • Fax: 409-769-1390
Mailing address:
  • Phone: 281-341-4881
  • Fax: 281-341-3056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number143202
License Number StateTX

VIII. Authorized Official

Name: JOSEPH FREUDENBERGER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 281-341-4881