Provider Demographics
NPI:1003839333
Name:BST HEALTH SERVICES CORP
Entity Type:Organization
Organization Name:BST HEALTH SERVICES CORP
Other - Org Name:THE VISTA AT BLUE SKIES OF TEXAS WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLUND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:210-838-6332
Mailing Address - Street 1:12455 FREEDOM WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3526
Mailing Address - Country:US
Mailing Address - Phone:210-838-6325
Mailing Address - Fax:210-838-6315
Practice Address - Street 1:5100 JOHN D RYAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3500
Practice Address - Country:US
Practice Address - Phone:210-568-3403
Practice Address - Fax:210-670-8159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115823311Z00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-5786OtherMEDICARE ID PTAN