MEDICARE: CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023407012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

Provider Business Mailing Address
First Line	:	5300 ALTAMESA BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-5924
Country	:	US
Telephone Number	:	817-346-1800
Fax Number	:	817-346-0149

Provider Business Practice Location Address
First Line	:	5300 ALTAMESA BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-5924
Country	:	US
Telephone Number	:	817-346-1800
Fax Number	:	817-346-0149

Authorized Official
Title or Position	:	CEO
Name	:	DAVID K BYROM
Credential	:
Telephone Number	:	254-248-6300

Provider Enumeration Date	:	01/14/2015
Last Update Date	:	01/23/2021

Similar Medicare Providers

1134117666 — FT. WORTH SOUTHWEST NURSING CENTER, LLC
Practice Location Address:

5300 ALTA MESA BLVD
FORT WORTH, TX
76133-5924

Practice Phone: 817-346-1800
Practice Fax: 817-346-0149

1386837680 — MS. AMANDA MARIE HILL
Practice Location Address:

5300 ALTAMESA BLVD
FORT WORTH, TX
76133-5924

Practice Phone: 817-346-1800
Practice Fax:

1003568916 — KATHERINE MOOS
Practice Location Address:

5300 ALTAMESA BLVD
FORT WORTH, TX
76133-5924

Practice Phone: 817-346-1800
Practice Fax:

1598181844 — SARAH WHEELER M.S. CCC-SLP
Practice Location Address:

5300 ALTAMESA BLVD
FT WORTH, TX
76133-5924

Practice Phone: 817-346-1800
Practice Fax:

1174922835 — KIMBERLY GRAYBEAL
Practice Location Address:

5300 ALTAMESA BLVD
FT WORTH, TX
76133-5924

Practice Phone: 817-346-1800
Practice Fax: 817-423-5842

1427519545 — AMANDA SIEG LPC
Practice Location Address:

5924 LAKESIDE DR
FORT WORTH, TX
76179-6612

Practice Phone: 817-668-0513
Practice Fax:

Directions to “CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.