Brentwood Healthcare, LTD

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

110093 Issued in TX

Legal business name

BRENTWOOD HEALTHCARE, LTD

Practice address

3505 S Buckner Blvd BLDG 4
Dallas, TX 75227-5451

Phone

(214) 381-1815

Fax

(214) 275-7618

NPI assigned

Oct 21, 2005

Organization subpart

No

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

Authorized official

Name

Dick Stebbins, CPA

Title

Pres of General Partner

Phone

(903) 757-5360

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Brentwood Place Three Doing business as

Locations

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1972592970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E WHALEY ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016525",
            "telephone_number": "903-757-5360",
            "fax_number": "903-236-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 S BUCKNER BLVD BLDG 4",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752275451",
            "telephone_number": "214-381-1815",
            "fax_number": "214-275-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD HEALTHCARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "STEBBINS",
        "authorized_official_first_name": "DICK",
        "authorized_official_title_or_position": "PRES OF GENERAL PARTNER",
        "authorized_official_telephone_number": "903-757-5360",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "110093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000498807",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112772203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HO6753525",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021919801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Place Three",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Claudimar Hernandez Brenner, NNP-BC
• Brent Parker, PA
• Shannon Brent, BS
• Brentwood Healthcare, LTD
• Brentwood Healthcare, LTD
• Neil A. Breslau, MD
• Peter Edward Bressler, MD
• Rachel Bressler, CCC-SLP
• Bret a Johnson MD, PA
• Brett Allan Gabriel

• Skilled Nursing Facility in Dallas, TX
• Providers in Dallas, 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 Sep 13, 2012; 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.