Organization Active NPI

Pend Oreille River Associates, LLC

  • Skilled Nursing Facility
  • Houston, TX
National Provider Identifier
1093890410
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PEND OREILLE RIVER ASSOCIATES, LLC
Doing business as
Legend Oaks Healthcare and REhabilitation - Northwest Houston
Practice address
8902 West Road
Houston, TX 77064-8635
Phone
(210) 564-0100
Fax
(210) 564-0157
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Martin Tomerlin
Title
President
Phone
(210) 564-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

8902 West Road
Houston, TX 77064-8635

Mailing address

1390 E Bitters Rd
San Antonio, TX 78216-2914
Phone (210) 564-0100

Other identifiers 1

IdentifierTypeStateIssuer
001015021MedicaidTX

Other names 1

  • Legend Oaks Healthcare and REhabilitation - Northwest Houston Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1063053Legend Oaks Healthcare and Rehabilitation Center-8902 West Road, Houston, TX 77064Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1093890410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 E BITTERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162914",
            "telephone_number": "210-564-0100",
            "fax_number": "210-564-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8902 WEST ROAD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770648635",
            "telephone_number": "210-564-0100",
            "fax_number": "210-564-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEND OREILLE RIVER ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "TOMERLIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-564-0100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001015021",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legend Oaks Healthcare and REhabilitation - Northwest Houston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.