Wichita Falls I Enterprises, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WICHITA FALLS I ENTERPRISES, LLC

Doing business as

University Park Nursing & Rehabilitation

Practice address

4511 Coronado Ave
Wichita Falls, TX 76310-2409

Phone

(940) 692-8001

NPI assigned

Dec 1, 2020

Last updated

Dec 1, 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

Gary Blake

Title

Managing Member

Phone

(817) 348-8959

Specialties & licenses 1

Addresses

Other names 1

• University Park Nursing & Rehabilitation Doing business as

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1477158244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ STE 600",
            "city": "FT 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": "4511 CORONADO AVE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763102409",
            "telephone_number": "940-692-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FALLS I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Park Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wichita Falls Endoscopy Center, LP (Wichita Falls Endoscopy Center)
• Wichita Falls Family Dental PLLC (Star Image Dentistry)
• Wichita Falls Gastroenterology Associates
• Wichita Falls Hearing LLC
• Wichita Falls Heart Clinic PLLC
• Wichita Falls Infectious Disease Assoc. P.a. (Robert L McBroom MD)
• Wichita Falls Isd
• Wichita Falls Kidney Clinic PA
• Wichita Falls Kidney Dialysis LLC
• Wichita Falls Nephrology Associates, PLLC

• Skilled Nursing Facility in Wichita Falls, TX
• Providers in Wichita Falls, 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 Dec 1, 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.