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Southwest Ltc - Waterton LLC

Skilled Nursing Facility in Tyler, TX · enumerated 2014 · authorized official Ronald Payne, Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1871919431

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Registry record

Entity type Organization (Type 2)
Legal business name Southwest Ltc - Waterton LLC
Other name <Unavail>
Practice address 2875 Shiloh Rd, Tyler, TX, 75703
Phone (903) 561-1300
Fax (903) 939-1754
Enumeration date Mar 6, 2014
Last updated in NPPES Feb 8, 2022

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities Primary

Authorized official

Name Ronald Payne
Title Manager
Phone (469) 916-6100

Other identifiers

Identifier Type State Issuer
103323 Medicaid TX -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2022-02-08. Verify at npiregistry.cms.hhs.gov.
Where is Southwest Ltc - Waterton LLC located?
The practice location on file with NPPES is in Tyler, TX.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-02-08.