Park Plaza LTC Partners, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARK PLAZA LTC PARTNERS, INC.

Practice address

2210 Howard St
San Angelo, TX 76901-1318

Phone

(325) 944-0561

Fax

(325) 944-0562

NPI assigned

Apr 27, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Louis Frederick Nicholson III, LNFA

Title

President

Phone

(832) 489-9944

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1770727455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 HOWARD ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769011318",
            "telephone_number": "325-944-0561",
            "fax_number": "325-944-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 HOWARD ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769011318",
            "telephone_number": "325-944-0561",
            "fax_number": "325-944-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLAZA LTC PARTNERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-489-9944",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "004561",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oxyatlantic Hospice, LLC
• Christopher Padilla, PA-C
• Jam Tipton Page, BCBA
• Paint Rock Isd
• Amin Parhizgar, M.D.
• Park Plaza Nursing Center, Inc
• James A. Parker Jr., MD
• John Porter Parker Jr., RPH
• Kimberly Jo Parks, M.A. CCC-SLP
• Shonna Y. Parks, CRNA

• Skilled Nursing Facility in San Angelo, TX
• Providers in San Angelo, 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 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.