# EL PASO V ENTERPRISES, 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
- **Other names:** Pebble Creek Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699256982
- **Authorized official:** GARY BLAKE (MANAGING MEMBER)
- **Authorized official phone:** (817) 348-8959

## Contact information

- **Practice address:** 11608 SCOTT SIMPSON DR, EL PASO, TX 79936-6210
- **Practice address phone:** (915) 857-0071
- **Practice address fax:** (915) 857-0118
- **Mailing address:** 4150 INTERNATIONAL PLZ STE 600, FORT WORTH, TX 76109-4831
- **Mailing address phone:** (915) 857-0071
- **Mailing address fax:** (915) 857-0118

## Taxonomy

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

## Other

- **Enumeration date:** 08/24/2018
- **Last updated:** 08/24/2018