MEDICARE: TRANSITIONAL HOSPITALS CORPORATION OF TEXAS, LLC

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	282E00000X	Long Term Care Hospital	000800	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	452028	OTHER	TX	SECURE HORIZONS
2	HH0920	OTHER	TX	BLUE CROSS
3	452028	OTHER	TX	GREAT WEST
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659440634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL HOSPITALS CORPORATION OF TEXAS, LLC

Provider Business Mailing Address
First Line	:	7800 OAKMONT BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4203
Country	:	US
Telephone Number	:	817-346-0094
Fax Number	:	817-263-4071

Provider Business Practice Location Address
First Line	:	7800 OAKMONT BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132
Country	:	US
Telephone Number	:	817-346-0094
Fax Number	:	817-263-4071

Authorized Official
Title or Position	:	DIR LICENSURE & CERTIFICATION
Name	:	JOHNETTA TRAYLOR
Credential	:
Telephone Number	:	502-596-6063

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	04/30/2026

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