Ambassador Health Care of Brady Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

108291 Issued in TX

Legal business name

AMBASSADOR HEALTH CARE OF BRADY INC

Practice address

5301 Duval Rd
Austin, TX 78727-6618

Phone

(512) 345-1805

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Theresa L Loftice

Title

Ar Manager

Phone

(972) 479-0766

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Duval Gardens Other name

Locations

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902993066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 INTERNATIONAL PKWY",
            "address_2": "SUITE 121",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750811897",
            "telephone_number": "972-479-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 DUVAL RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787276618",
            "telephone_number": "512-345-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR HEALTH CARE OF BRADY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOFTICE",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "972-479-0766",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "108291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4970",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Duval Gardens",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Skilled Nursing Facility in Austin, TX
• Providers in Austin, 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 Aug 22, 2020; 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.