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NPI Code Detail

MEDICARE: HSMTX/REUNION PLAZA, LLC

MEDICARE: HSMTX/REUNION PLAZA, LLC
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
1314000000XSkilled Nursing Facility114375TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770649659
Entity Type Code : Organization
Provider Name (Legal Business Name) : HSMTX/REUNION PLAZA, LLC
Provider Business Mailing Address
First Line : 5300 HOLLISTER ST
Second Line : SUITE 550
City : HOUSTON
State : TX
Zip : 77040-6137
Country : US
Telephone Number : 713-934-7800
Fax Number : 713-895-0064
Provider Business Practice Location Address
First Line : 1401 RICE RD
Second Line :
City : TYLER
State : TX
Zip : 75703-3233
Country : US
Telephone Number : 903-561-6060
Fax Number : 903-534-8045
Authorized Official
Title or Position : VP FINANCE
Name : CHARLES A DAVIS
Credential :
Telephone Number : 713-934-7800
Provider Enumeration Date : 12/28/2006
Last Update Date : 12/28/2009

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Directions to “HSMTX/REUNION PLAZA, LLC ” Practice Location

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