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Contact Information

BANYAN TEXAS, LLC
4168 COUNTY ROAD 444
WAELDER, TX78959-5328
 Phone: 830-283-3003
 Fax: 830-522-2003
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
 

Psychiatric Hospital

283Q00000X A0[7] Hospital-Psychiatric (PPS excluded)
 

Rehabilitation, Substance Use Disorder

261QR0405X
Indicates primary specialty

NPI Profile & details for BANYAN TEXAS, LLC

NPI # 1629689559
LBN Legal business name BANYAN TEXAS, LLC
Authorized official JOHN SORY - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/13/2020
Last updated 05/13/2025 - More than a year ago
Identifiers
TX Medicaid 4238503
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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