Basic Information
| Provider Information | |||||||||
| NPI: | 1942667928 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OAKBEND MEDICAL CENTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LARKSPUR | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1705 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774693246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813414881 | ||||||||
| FaxNumber: | 2813413056 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 S JOHN REDDITT DR | ||||||||
| Address2: | |||||||||
| City: | LUFKIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 759043142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9366323346 | ||||||||
| FaxNumber: | 9366377865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2016 | ||||||||
| LastUpdateDate: | 01/22/2016 | ||||||||
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| AuthorizedOfficialLastName: | FREUDENBERGER | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2813414881 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 141191 | TX | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.