Basic Information
| Provider Information | |||||||||
| NPI: | 1164419958 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIDALGO NURSING HOME LIMITED PARTNERSHIP | ||||||||
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| OtherOrganizationName: | MISSION NURSING AND REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6633 E HIGHWAY 290 STE 202 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787231157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124585707 | ||||||||
| FaxNumber: | 5124585751 | ||||||||
| Practice Location | |||||||||
| Address1: | 1013 S BRYAN RD | ||||||||
| Address2: | |||||||||
| City: | MISSION | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785726608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124585707 | ||||||||
| FaxNumber: | 5124585751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HIMMEL | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5124585707 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | 112821 | TX | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.