Basic Information
| Provider Information | |||||||||
| NPI: | 1417941303 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SOUTHWEST LTC CUERO LTD | ||||||||
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| OtherOrganizationName: | WHISPERING OAKS NURSING HOME | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17760 PRESTON RD | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752525663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4699166100 | ||||||||
| FaxNumber: | 4699166105 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | CUERO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779546400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3612753421 | ||||||||
| FaxNumber: | 3612758640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KRESS | ||||||||
| AuthorizedOfficialFirstName: | ERIN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4699166100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 004919 | TX | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.