Mason Georgetown Op LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

134293 Issued in TX

Legal business name

MASON GEORGETOWN OP LLC

Doing business as

Estrella Oaks Rehabilitation and Care Center

Practice address

4011 Williams Dr
Georgetown, TX 78628-2491

Phone

(512) 868-2700

Fax

(512) 868-2999

NPI assigned

Oct 25, 2010

Last updated

Aug 2, 2012By 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

Brian R. Threadgill

Title

Administrator

Phone

(512) 868-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Estrella Oaks Rehabilitation and Care Center Doing business as

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1285934232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282491",
            "telephone_number": "512-868-2700",
            "fax_number": "512-868-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282491",
            "telephone_number": "512-868-2700",
            "fax_number": "512-868-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON GEORGETOWN OP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "THREADGILL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-868-2700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "134293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "104710",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019243",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Estrella Oaks Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gerardo Martinez
• Jennifer Martinez
• Mary & Ralph Pharmacy Inc (Gallagher's Pharmacy)
• Mary Piatt Counseling, PLLC
• Jacqueline Grace Mascari, MS, LP, RPT
• Bradley Keith Mason, LPC
• Elise Mason, MS NP-C
• Karime C Massey, ANP
• Ana Mata
• Michael Ross Matthys, D.C.

• Skilled Nursing Facility in Georgetown, TX
• Providers in Georgetown, 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 Aug 2, 2012; 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.