Healthcare Provider Details

I. General information

NPI: 1265653281
Provider Name (Legal Business Name): CHG CORNERSTONE HOSPITAL OF CENTRAL TEXAS, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W BEN WHITE BLVD 3RD FLOOR NE
AUSTIN TX
78704-6903
US

IV. Provider business mailing address

13455 NOEL RD SUITE 1320
DALLAS TX
75240-6620
US

V. Phone/Fax

Practice location:
  • Phone: 512-706-1900
  • Fax: 512-706-1901
Mailing address:
  • Phone: 469-621-6700
  • Fax: 469-621-6672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number008281
License Number StateTX

VIII. Authorized Official

Name: MRS. STACIE A SNIDER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 469-621-6715