Organization
EAGLE LAKE NURSING AND REHABILITATION, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN D FLAGG (CEO)
(940) 387-4388
Entity
Organization
Contact information
Practice address
535 S AUSTIN ROAD, EAGLE LAKE, TX 77434
(979) 243-3910
(979) 234-2926
Mailing address
419 S ELM ST, DENTON, TX 76201-6085
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
139519
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001025414
—
TX
01
—
339186401
TMHP CROSS OVER
TX
Enumeration date
08/09/2013
Last updated
02/15/2019
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