Legend Healthcare Gladewater, LP

Organization Active NPI Skilled Nursing Facility · Gladewater, TX

NPI 1508953399 · NPPES record last updated Mar 25, 2015

Key facts

NPI
1508953399
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
5326 (TX)
Legal business name
LEGEND HEALTHCARE GLADEWATER, LP
Practice address
1201 FM 2685
Gladewater, TX 75647
Phone
(903) 845-2175
Fax
(903) 844-2435
NPI assigned
Oct 5, 2006
Organization subpart
No

Authorized official

Name
Martin Tomerlin
Title
President
Phone
(210) 564-0100

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5326 TX Yes

Addresses

Primary practice location

1201 FM 2685
Gladewater, TX 75647

Mailing address

1390 E Bitters Rd
San Antonio, TX 78216-2914
Phone (210) 564-0100

Other identifiers

IdentifierTypeStateIssuer
001012874MedicaidTX

Other names

  • Legend Oaks Healthcare and Rehab Ctr - Gladewater Doing business as

Other providers in Gladewater, TX

All providers in Gladewater, TX · Skilled Nursing Facility in Texas

Sources for this page

Verify at the official NPI Registry.