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General NPI Number Information
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NPI Number | 1407023518
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Entity Type | Organization
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Legal Business Name | WEST TEXAS LTC PARTNERS, INC.
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 01/20/2018
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Provider Practice Location Address
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Address Line | 1915 GREENWOOD ST
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City | SAN ANGELO
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State | TX
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Zip | 76901-1112
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Country | US
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Telephone | 325-942-0677
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Fax | 325-942-1331
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Provider Business Mailing Address
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Address Line | 1915 GREENWOOD ST
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City | SAN ANGELO
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State | TX
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Zip | 76901-1112
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Country | US
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Telephone | 325-942-0677
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Fax | 325-942-1331
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LOUIS FREDERICK NICHOLSON III
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Credential | LNFA
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Telephone | 832-489-9944
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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 | 001016152
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 676068
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 5236
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 124667
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License Number State | TX
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