Provider Demographics
NPI:1457316176
Name:OAKBEND MEDICAL CENTER
Entity Type:Organization
Organization Name:OAKBEND MEDICAL CENTER
Other - Org Name:HERITAGE PARK REHABILITATION AND SKILLED NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUDENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-341-4881
Mailing Address - Street 1:2806 REAL ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722-1715
Mailing Address - Country:US
Mailing Address - Phone:512-474-1411
Mailing Address - Fax:512-474-5401
Practice Address - Street 1:2806 REAL ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722-1715
Practice Address - Country:US
Practice Address - Phone:512-474-1411
Practice Address - Fax:512-474-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114618313M00000X
TX455599314000000X
TX1237440001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001026680Medicaid
TX000478107Medicaid
TXHH2738OtherBCBS BLUE LINK
TX011178301Medicaid
TX198027801Medicaid
TX478107Medicaid
TX198027801Medicaid
TX478107Medicaid
TX1237440001Medicare NSC
TX455599Medicare Oscar/Certification