Provider Demographics
NPI:1124070511
Name:OAKBEND MEDICAL CENTER
Entity type:Organization
Organization Name:OAKBEND MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUDENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-341-4812
Mailing Address - Street 1:1705 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3246
Mailing Address - Country:US
Mailing Address - Phone:281-341-4881
Mailing Address - Fax:281-341-3056
Practice Address - Street 1:1405 VALHALLA DR
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-9218
Practice Address - Country:US
Practice Address - Phone:979-532-1244
Practice Address - Fax:979-532-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112200314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5227Medicaid
TX5227Medicaid