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Organization

HSMTX WATERTON PLAZA, LLC

Active
Other names
The Waterton Plaza Senior Care
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES A DAVIS (VP FINANCE)
(713) 934-7800
Entity
Organization

Contact information

Practice address
2875 SHILOH RD, TYLER, TX 75703-2936
(903) 561-1300
(903) 939-1754
Mailing address
5300 HOLLISTER ST, SUITE 550, HOUSTON, TX 77040-6137
(713) 934-7800
(713) 895-0064

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001017767
TX
Enumeration date
12/05/2007
Last updated
02/16/2010
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