Provider Demographics
NPI:1629395850
Name:MEXIA LTC PARTNERS, INC.
Entity Type:Organization
Organization Name:MEXIA LTC PARTNERS, INC.
Other - Org Name:MEXIA LTC NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:III
Authorized Official - Credentials:LNFA
Authorized Official - Phone:832-489-9944
Mailing Address - Street 1:601 TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-2072
Mailing Address - Country:US
Mailing Address - Phone:254-562-5400
Mailing Address - Fax:254-562-9145
Practice Address - Street 1:601 TERRACE LN
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2072
Practice Address - Country:US
Practice Address - Phone:254-562-5400
Practice Address - Fax:254-562-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004868OtherFACILITY IDENTIFICATION NUMBER
TX675903Medicare PIN