Provider Demographics
NPI:1164404778
Name:TEXAS HERITAGE OAKS
Entity Type:Organization
Organization Name:TEXAS HERITAGE OAKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:NFA , LSW
Authorized Official - Phone:806-795-8792
Mailing Address - Street 1:5301 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4940
Mailing Address - Country:US
Mailing Address - Phone:806-795-8792
Mailing Address - Fax:806-785-8741
Practice Address - Street 1:5301 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4940
Practice Address - Country:US
Practice Address - Phone:806-795-8792
Practice Address - Fax:806-785-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112129313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility