Laredo Operator LTD

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAREDO OPERATOR LTD

Practice address

1701 Tournament Trail Drive
Laredo, TX 78041

Phone

(210) 828-5686

Fax

(210) 798-0725

NPI assigned

Sep 12, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Carl Fellbaum

Title

Ceo

Phone

(210) 828-5686

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laredo Nursing Rehabilition Ctr Doing business as

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1780966143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 NE LOOP 410",
            "address_2": "SUITE 640",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091204",
            "telephone_number": "210-828-5686",
            "fax_number": "210-798-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 TOURNAMENT TRAIL DRIVE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "210-828-5686",
            "fax_number": "210-798-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAREDO OPERATOR LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-12",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "FELLBAUM",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-828-5686",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020466",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laredo Nursing Rehabilition Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Laredo, TX
• Providers in Laredo, 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 9, 2015; 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.