Bryan SNF, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BRYAN SNF, LLC

Doing business as

Isle at Watercrest-Bryan

Practice address

4091 Eastchester Dr
Bryan, TX 77802-4732

Phone

(979) 774-3401

Fax

(979) 774-3021

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Craig Willard Spaulding, CPA

Title

Manager

Phone

(214) 370-2600

Specialties & licenses 1

Addresses

Other names 1

• Isle at Watercrest-Bryan Doing business as

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1841509015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 E MOCKINGBIRD LN",
            "address_2": "SUITE 1010",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065109",
            "telephone_number": "214-370-2600",
            "fax_number": "214-370-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4091 EASTCHESTER DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024732",
            "telephone_number": "979-774-3401",
            "fax_number": "979-774-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "SPAULDING",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "WILLARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-370-2600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Isle at Watercrest-Bryan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Bryan, TX
• Providers in Bryan, 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 11, 2011; 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.