NPIMap

Organization Active NPI

Texada, Inc

  • Skilled Nursing Facility
  • Abilene, TX
National Provider Identifier
1528296662
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
127499 Issued in TX
Legal business name
TEXADA, INC
Practice address
3202 S Willis St
Abilene, TX 79605-6650
Phone
(325) 692-6145
Fax
(325) 692-6145
NPI assigned
Jun 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Authorized official

Name
Dr. Carroll Bruce Davis, PHD
Title
President
Phone
(325) 692-6145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 127499 TX Primary

Addresses

Primary practice location

3202 S Willis St
Abilene, TX 79605-6650

Mailing address

3202 S Willis St
Abilene, TX 79605-6650
Phone (325) 692-6145

Other identifiers 1

IdentifierTypeStateIssuer
001017200MedicaidTX

Other names 1

  • Wisteria Place Nursing & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1246147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1528296662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 S WILLIS ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796056650",
            "telephone_number": "325-692-6145",
            "fax_number": "325-695-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 S WILLIS ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796056650",
            "telephone_number": "325-692-6145",
            "fax_number": "325-692-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXADA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-28",
        "last_updated": "2009-09-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "325-692-6145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "127499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017200",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wisteria Place Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; 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.