Provider Demographics
NPI:1306953344
Name:REGENT CARE CENTER OF SAN ANTONIO, LP
Entity type:Organization
Organization Name:REGENT CARE CENTER OF SAN ANTONIO, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:OSTERMAYER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:409-763-6000
Mailing Address - Street 1:2302 POST OFFICE ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1913
Mailing Address - Country:US
Mailing Address - Phone:409-763-6000
Mailing Address - Fax:409-770-0233
Practice Address - Street 1:16400 BLANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1902
Practice Address - Country:US
Practice Address - Phone:210-408-1212
Practice Address - Fax:210-408-0486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111317314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000533701Medicaid
TX675432Medicare Oscar/Certification
TX000533701Medicaid