CB-Sealy Nursing Home,Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

100852 Issued in TX

Legal business name

CB-SEALY NURSING HOME,INC.

Practice address

1401 Eagle Lake Rd
Sealy, TX 77474-3109

Phone

(979) 885-2937

Fax

(979) 627-0780

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Tim Pawlowski

Title

Owner

Phone

(979) 885-2937

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260489600000",
    "number": "1598846412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAGLE LAKE RD",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774743109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 EAGLE LAKE RD",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774743109",
            "telephone_number": "979-885-2937",
            "fax_number": "979-627-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CB-SEALY NURSING HOME,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-12-11",
        "status": "A",
        "authorized_official_last_name": "PAWLOWSKI",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-885-2937"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "100852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003328",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5424",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Denise Brast, LPC, LSOTP
• Brazos Isd
• Brazos Physical Rehabilitation, LLC
• Bsquared, LLC (Healthmax Pharmacy)
• Stephanie Burttschell
• Cedar Home
• Jincy Cherian, NURSE PRACTITIONER
• Monica Chica
• Charles Reginald Cleveland Jr., DDS
• Columbus Optical Company, LTD.

• Nursing Facility/Intermediate Care Facility in Sealy, TX
• Providers in Sealy, TX by specialty
• Nursing Facility/Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.