Healthcare Provider Details

I. General information

NPI: 1962491662
Provider Name (Legal Business Name): ANAHUAC HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOSPITAL DRIVE
ANAHUAC TX
77514-1723
US

IV. Provider business mailing address

PO BOX W
ANAHUAC TX
77514-1723
US

V. Phone/Fax

Practice location:
  • Phone: 409-267-3164
  • Fax: 409-267-3764
Mailing address:
  • Phone: 409-267-3164
  • Fax: 409-267-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number112909
License Number StateTX

VIII. Authorized Official

Name: MRS. CINDY RANDLE
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 409-267-3164