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General NPI Number Information
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NPI Number | 1073742599
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Entity Type | Organization
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Legal Business Name | CWP HEALTHCARE OF EDGEWATER LLC
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 2228 SEAWALL BLVD
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City | GALVESTON
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State | TX
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Zip | 77550-8940
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Country | US
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Telephone | 972-818-7500
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Fax | 972-732-6644
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Provider Business Mailing Address
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Address Line | 5305 VILLAGE CREEK DR
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City | PLANO
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State | TX
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Zip | 75093-4810
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Country | US
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Telephone | 972-818-7500
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Fax | 972-732-6644
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES WILLIAM PUTNAM JR.
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Credential |
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Telephone | 972-818-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | TX
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