Organization
TEXADA, INC
Active
Other names
Wisteria Place Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARROLL BRUCE DAVIS PHD (PRESIDENT)
(325) 692-6145
Entity
Organization
Contact information
Practice address
3202 S WILLIS ST, ABILENE, TX 79605-6650
(325) 692-6145
(325) 692-6145
Mailing address
3202 S WILLIS ST, ABILENE, TX 79605-6650
(325) 692-6145
(325) 695-2629
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
127499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001017200
—
TX
Enumeration date
06/28/2009
Last updated
09/04/2009
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