Gold Star Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

030299 Issued in TX

Legal business name

GOLD STAR ASSISTED LIVING

Practice address

503 W Highway 243
Canton, TX 75103-2113

Phone

(903) 567-2762

Fax

(903) 567-2237

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By 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

Mr. Jerry Lynn Tidwell

Title

Manager

Phone

(903) 567-2762

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396960993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751037090",
            "telephone_number": "903-567-2762",
            "fax_number": "309-567-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 W HIGHWAY 243",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751032113",
            "telephone_number": "903-567-2762",
            "fax_number": "903-567-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD STAR ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "903-567-2762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "030299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foot Clinic of East Texas, PC
• Forever Kids Pediatric Clinic
• Brandi Jo Foster
• Kaitlin Franklin
• Nicholas J Galloway II, DC
• Virginia Yolanda Gonzalez, M.D.
• Deanna Lindsley Goode, PT
• Krystal Gore
• Stacie Gressley, CCC/SLP
• Tera Grimes, DC

• Assisted Living Facility in Canton, TX
• Providers in Canton, 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 Aug 22, 2020; 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.