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General NPI Number Information
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NPI Number | 1063469674
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Entity Type | Organization
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Legal Business Name | TEXARKANA NURSING & HEALTHCARE
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 4920 ELIZABETH ST
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City | TEXARKANA
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State | TX
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Zip | 75503-2912
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Country | US
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Telephone | 903-792-3812
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Fax | 903-792-9661
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Provider Business Mailing Address
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Address Line | 4920 ELIZABETH ST
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City | TEXARKANA
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State | TX
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Zip | 75503-2912
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Country | US
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Telephone | 903-792-3812
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Fax | 903-792-9661
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Authorized Official
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Title or Position | ADMINISTRATOR OWNER
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Name | MRS. ANN ELLISOR
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Credential |
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Telephone | 903-792-3812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number | 115026
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License Number State | TX
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