Tandy Village Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

125808 Issued in TX

Legal business name

TANDY VILLAGE ASSISTED LIVING

Doing business as

Romans House LLC

Practice address

2601 Tandy Ave
Fort Worth, TX 76103-2552

Phone

(817) 535-1253

Fax

(817) 536-0177

NPI assigned

Jan 21, 2009

Last updated

Jan 21, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Nellie S. Queton

Title

Business Office Manager

Phone

(817) 535-1253

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Romans House LLC Doing business as

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1215174727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 TANDY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761032552",
            "telephone_number": "817-535-1253",
            "fax_number": "817-536-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 TANDY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761032552",
            "telephone_number": "817-535-1253",
            "fax_number": "817-536-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANDY VILLAGE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "QUETON",
        "authorized_official_first_name": "NELLIE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "817-535-1253",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "125808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPT OF AGING AND DISABILITY- DADS",
            "identifier": "000964",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Romans House LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Domingo K Tan, MD
• Natalia Handrayani Tan, PA-C
• Yue-Qing Tan, MD
• Anson Tang
• Ethan Tang, MD
• Brooke Tankleff
• Bhavna Nitin Tanna, M.D.
• Sonya Amratlal Tanna, PA

• Assisted Living Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.