Cedar Bayou SCC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CEDAR BAYOU SCC LLC

Doing business as

Cedar Bayou Nursing & Rehab Center

Practice address

2000 W Baker Rd
Baytown, TX 77521-2259

Phone

(281) 427-9120

Fax

(281) 427-4262

NPI assigned

Dec 30, 2014

Last updated

Mar 4, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cedar Bayou Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1730577636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BAKER RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775212259",
            "telephone_number": "281-427-9120",
            "fax_number": "281-427-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR BAYOU SCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR ID/FACILITY ID",
            "identifier": "5541 103620",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026731",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Bayou Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cedar Bayou Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dolores Casey, NP
• Caso Case Management Services, Inc.
• Alondra Castellanos, PT, DPT
• Cassadi Dlo Cazares, PHARMD
• Cedar Bayou Medical Clinic, LLC
• Mindy Marie Cedillo, RDMS(AB,OB/GYN), RVT
• Centerwell Senior Primary Care (TX) PA (CenterWell Senior Primary Care-Baytown)
• Shaunteel L Chalk, CNM
• Lyla S Challa, MD
• Sarma S Challa, M.D.

• Skilled Nursing Facility in Baytown, TX
• Providers in Baytown, 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 4, 2020; 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.