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General NPI Number Information
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NPI Number | 1942200720
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Entity Type | Organization
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Legal Business Name | STATE OF TEXAS VETERANS LAND BOARD
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 200 VETERANS DRIVE
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City | FLORESVILLE
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State | TX
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Zip | 78114-2709
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Country | US
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Telephone | 830-216-9456
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Fax | 830-393-7764
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Provider Business Mailing Address
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Address Line | 1700 NORTH CONGRESS AVENUE RM 810
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City | AUSTIN
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State | TX
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Zip | 78701-1496
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Country | US
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Telephone | 512-936-6929
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Fax | 512-475-2294
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Authorized Official
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Title or Position | CHAIRMAN, TEXAS VETERANS LAND BOARD
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Name | MR. JERRY E. PATTERSON
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Credential |
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Telephone | 512-475-2336
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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 | 100260
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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 |
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License Number State |
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