Eagle Lake Nursing and Rehabilitation, LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

139519 Issued in TX

Legal business name

EAGLE LAKE NURSING AND REHABILITATION, LP

Practice address

535 S Austin Road
Eagle Lake, TX 77434

Phone

(979) 243-3910

Fax

(979) 234-2926

NPI assigned

Aug 9, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Dan D Flagg

Title

Ceo

Phone

(940) 387-4388

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1740613009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762016085",
            "telephone_number": "940-387-4388",
            "fax_number": "940-380-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S AUSTIN ROAD",
            "city": "EAGLE LAKE",
            "state": "TX",
            "postal_code": "77434",
            "telephone_number": "979-243-3910",
            "fax_number": "979-234-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE LAKE NURSING AND REHABILITATION, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-09",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "FLAGG",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-387-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "139519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025414",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP CROSS OVER",
            "identifier": "339186401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Joyce Cunningham
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• Eagle Lake Community Hospital
• Eagle Lake Drugstore
• Patricia Marie Eagle
• Melanie Farrell, PA-C
• Brittnee Nicole Flowers
• Linda Harris
• Meek Medical Transportation Services

• Skilled Nursing Facility in Eagle Lake, TX
• Providers in Eagle Lake, 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 Feb 15, 2019; 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.