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Organization
SOUTHWEST LTC GULF HEALTHCARE LTD
Active
Organization
SOUTHWEST LTC GULF HEALTHCARE LTD
Active
Other names
Gulf Healthcare Center Port Arthur
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD R PAYNE ESQ. (CEO)
(469) 916-6100
Entity
Organization
Contact information
Practice address
6600 9TH AVE, PORT ARTHUR, TX 77642-6411
(469) 916-6100
(469) 916-6105
Mailing address
1518 LEGACY DR, SUITE 110, FRISCO, TX 75034-6038
(469) 916-6100
(469) 916-6105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
005322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5322
—
TX
Enumeration date
09/06/2005
Last updated
06/02/2015
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