# SOUTHWEST LTC--BRADY WEST, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brady West Nursing and Convalescent Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467439976
- **Authorized official:** MR. RONALD R. PAYNE ESQ. (MANAGING MEMBER)
- **Authorized official phone:** (469) 916-6100

## Contact information

- **Practice address:** 2201 MENARD HWY, BRADY, TX 76825-7432
- **Practice address phone:** (325) 597-2906
- **Practice address fax:** (325) 597-2555
- **Mailing address:** 17760 PRESTON RD, SUITE 310, DALLAS, TX 75252-5663
- **Mailing address phone:** (469) 916-6100
- **Mailing address fax:** (469) 916-6105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 004744 | TX | Yes |

## Other

- **Enumeration date:** 12/27/2005
- **Last updated:** 08/22/2020