S.U.R. LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

127476 Issued in TX

Legal business name

S.U.R. LLC

Practice address

2630 Old Anson Rd
Abilene, TX 79603-2210

Phone

(325) 673-5101

Fax

(325) 673-0568

NPI assigned

Apr 17, 2009

Organization subpart

No

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

Authorized official

Name

Monte Randall

Title

VP of Operations

Phone

(940) 374-3804

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Abilene Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1659514867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 FM 2210 E",
            "city": "POOLVILLE",
            "state": "TX",
            "postal_code": "764875028",
            "telephone_number": "940-374-3804",
            "fax_number": "940-374-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 OLD ANSON RD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796032210",
            "telephone_number": "325-673-5101",
            "fax_number": "325-673-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.U.R. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-17",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "MONTE",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "940-374-3804"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "127476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017082",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "004892",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abilene Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Russell Liles, O.D., PLLC
• Russell S Dickerson MD
• Roger A Russell, PHD
• Marsha Dawn Rutland, PT
• Neelima Ryali, M.D.
• Macarena Andrea Saavedra Olguin
• Todd D Sage, OTR
• Chelsea Marie Sain
• Michelle Saksa, MOT, OTR/L
• Amanda Ray Salas, PHARM D

• Skilled Nursing Facility in Abilene, TX
• Providers in Abilene, 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 Jan 12, 2010; 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.