MEDICARE: SARAH ROBERTS FRENCH HOME

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	332B00000X	Durable Medical Equipment & Medical Supplies	1029640001	TX
2	313M00000X	Nursing Facility/Intermediate Care Facility	4373	TX

General Provider Information

NPI Number	:	1609873272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH ROBERTS FRENCH HOME

Provider Business Mailing Address
First Line	:	1315 TEXAS AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-5944
Country	:	US
Telephone Number	:	210-736-4238
Fax Number	:	210-737-7151

Provider Business Practice Location Address
First Line	:	1315 TEXAS AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-5944
Country	:	US
Telephone Number	:	210-736-4238
Fax Number	:	210-737-7151

Authorized Official
Title or Position	:	NURSING FACILITY ADMINISTRATOR
Name	:	MS. MONA LISA RUDD
Credential	:
Telephone Number	:	210-736-4238

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	05/05/2022

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