Provider Demographics
NPI:1871633305
Name:OAKBEND MEDICAL CENTER
Entity Type:Organization
Organization Name:OAKBEND MEDICAL CENTER
Other - Org Name:S.P.J.S.T. REST HOME 1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CE0
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUDENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-341-4812
Mailing Address - Street 1:1810 OLD GRANGER
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-3564
Mailing Address - Country:US
Mailing Address - Phone:512-352-6337
Mailing Address - Fax:
Practice Address - Street 1:1810 OLD GRANGER
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-3564
Practice Address - Country:US
Practice Address - Phone:512-352-6337
Practice Address - Fax:512-352-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45E665Medicaid
TX676290Medicare PIN