Legend Healthcare Euless, LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5041 Issued in TX

Legal business name

LEGEND HEALTHCARE EULESS, LP

Doing business as

Legend Healthcare and Rehab - Euless

Practice address

900 Westpark Way
Euless, TX 76040-3977

Phone

(817) 545-4071

Fax

(817) 684-8341

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Martin Tomerlin

Title

President

Phone

(210) 564-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Legend Healthcare and Rehab - Euless Doing business as

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1497856413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 E BITTERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162914",
            "telephone_number": "210-564-0100",
            "fax_number": "210-564-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WESTPARK WAY",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760403977",
            "telephone_number": "817-545-4071",
            "fax_number": "817-684-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND HEALTHCARE EULESS, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "TOMERLIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-564-0100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "5041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012869",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legend Healthcare and Rehab - Euless",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia Marie Lapucha, DO
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• Heather Rachelle Lindstrom, PHD

• Skilled Nursing Facility in Euless, TX
• Providers in Euless, 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 Mar 25, 2015; 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.