Shady Shores of El Paso, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHADY SHORES OF EL PASO, LLC

Practice address

1600 Murchison Dr
El Paso, TX 79902-2828

Phone

(915) 544-2002

Fax

(915) 544-0696

NPI assigned

Jan 29, 2016

Organization subpart

No

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

Authorized official

Name

Michael Wallace

Title

Ceo

Phone

(214) 422-1622

Specialties & licenses 1

Addresses

Other names 1

• Mountain View Health & Rehabilitation Doing business as

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1922466499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAGLE DR",
            "address_2": "SUITE 201",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762016898",
            "telephone_number": "214-422-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MURCHISON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799022828",
            "telephone_number": "915-544-2002",
            "fax_number": "915-544-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY SHORES OF EL PASO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-422-1622"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Health & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Yvonne Seyffert
• James Seymour, D.O.
• Jessica Seymour, LCSW
• Hisham Issa Shabani, MD
• Tolulope Shada, MD, MPH
• Nazish Shafi, M.D.
• Sarina Shafiyan-Rad
• Arjav Shah, MD
• Haritha Shah
• Jirga Shah, DDS

• Skilled Nursing Facility in El Paso, TX
• Providers in El Paso, 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 29, 2016; 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.