San Angelo I Enterprises, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAN ANGELO I ENTERPRISES, LLC

Practice address

2210 Howard St
San Angelo, TX 76901-1318

Phone

(325) 944-0561

Fax

(325) 944-0562

NPI assigned

May 30, 2023

Organization subpart

No

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

Authorized official

Name

Gary Blake

Title

Managing Member

Phone

(817) 348-8959

Specialties & licenses 1

Addresses

Other names 1

• Park Plaza Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1265125041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ STE 600",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094831",
            "telephone_number": "817-348-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 HOWARD ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769011318",
            "telephone_number": "325-944-0561",
            "fax_number": "325-944-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANGELO I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8959"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Plaza Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Angelo ER LLC
• San Angelo Health Care, LLC
• San Angelo Hospital LP
• San Angelo Hospital LP
• San Angelo Hospital, LP
• San Angelo II Enterprises, LLC
• San Angelo Independent School District
• San Angelo Neurosurgical Association
• San Angelo Pediatric Associates, P.a.
• San Angelo Psychiatric Association, PLLC

• Skilled Nursing Facility in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.