Three Rivers Nursing Home, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

136010 Issued in TX

Legal business name

THREE RIVERS NURSING HOME, LLC

Practice address

1717 45TH St.
Three Rivers, TX 78071-2649

Phone

(361) 786-2256

Fax

(361) 786-2456

NPI assigned

Oct 12, 2006

Last updated

Jun 19, 2013By 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

Mr. Ronald L Vidrine

Title

Owner

Phone

(361) 786-2256

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1891885943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 45TH ST.",
            "city": "THREE RIVERS",
            "state": "TX",
            "postal_code": "780712649",
            "telephone_number": "361-786-2256",
            "fax_number": "361-786-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 45TH ST.",
            "city": "THREE RIVERS",
            "state": "TX",
            "postal_code": "780712649",
            "telephone_number": "361-786-2256",
            "fax_number": "361-786-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS NURSING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "VIDRINE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-786-2256",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "112944",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "131278",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "136010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012235",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Texas Medical PA (Valero Employee Wellness Center)
• Cary A Pruski, DDS
• Soliz Physical Therapy PLLC (Momentum Physcial Therapy)
• Dusty D Soliz, P.T.
• Three Rivers Isd
• Three Rivers Pharmacy, LLC (Campbell Drug Store)
• Three Rivers Pharmacy, LLC (Campbell Drug Store)
• Jordan Alyse Zabransky, FNP-C
• Roselia Zamora-Pollard, NP

• Skilled Nursing Facility in Three Rivers, TX
• Providers in Three Rivers, 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 Jun 19, 2013; 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.