MEDICARE: SAN ANTONIO ASSISTED LIVING, LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	117728	TX

General Provider Information

NPI Number	:	1386711471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN ANTONIO ASSISTED LIVING, LTD.

Provider Business Mailing Address
First Line	:	9595 SIX PINES RD
Second Line	:	SUITE 6300
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6849 CRESTWAY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239-2321
Country	:	US
Telephone Number	:	210-946-4994
Fax Number	:	210-946-5775

Authorized Official
Title or Position	:	COO AND PARTNER
Name	:	MR. LAURENCE DASPIT
Credential	:
Telephone Number	:	281-362-3502

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/22/2020

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