# MSHC THE WATERTON AT COWHORN CREEK, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255497137
- **Authorized official:** CARLA POWER (CFO)
- **Authorized official phone:** (903) 534-8667

## Contact information

- **Practice address:** 5524 COWHORN CREEK RD, TEXARKANA, TX 75503-9101
- **Practice address phone:** (903) 228-1188
- **Practice address fax:** (903) 838-1229
- **Mailing address:** 1901 RICKETY LN, STE 208, TYLER, TX 75703-1703
- **Mailing address phone:** (903) 534-8667
- **Mailing address fax:** (903) 509-0026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 115905 | TX | Yes |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 09/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001013766 | — | TX |