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General NPI Number Information
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NPI Number | 1104910884
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3839 MEGAN STREET
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City | EAGLE PASS
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State | TX
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Zip | 78852
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Country | US
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Telephone | 830-758-1889
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Fax | 830-758-1714
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Provider Business Mailing Address
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Address Line | 590 EAST MAIN STREET SUITE E
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City | EAGLE PASS
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State | TX
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Zip | 78852
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Country | US
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Telephone | 830-758-1889
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Fax | 830-758-1714
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Authorized Official
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Title or Position | PRESIDENT COO
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Name | MR. JOE B DAWSON JR.
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Credential | BA, MA, LNFA, LHA
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Telephone | 830-758-1889
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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 | 9337
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License Number State | TX
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