Basic Information
Provider Information
NPI: 1316337330
EntityType: 2
ReplacementNPI:  
OrganizationName: ER OPCO ML LLC
LastName:  
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Mailing Information
Address1: 16044 COUNTY ROAD 165
Address2:  
City: TYLER
State: TX
PostalCode: 757037302
CountryCode: US
TelephoneNumber: 9035265599
FaxNumber: 9035263717
Practice Location
Address1: 16044 COUNTY ROAD 165
Address2:  
City: TYLER
State: TX
PostalCode: 757037302
CountryCode: US
TelephoneNumber: 9035265599
FaxNumber: 9035263717
Other Information
ProviderEnumerationDate: 01/28/2015
LastUpdateDate: 10/25/2017
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: COATES
AuthorizedOfficialFirstName: CHRISTOPHER
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 6159152932
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X TXY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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