Healthcare Provider Details

I. General information

NPI: 1700876497
Provider Name (Legal Business Name): UVALDE COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3759 VALLEY VIEW RD
AUSTIN TX
78704-5921
US

IV. Provider business mailing address

3759 VALLEY VIEW RD
AUSTIN TX
78704-5921
US

V. Phone/Fax

Practice location:
  • Phone: 512-443-3436
  • Fax: 512-445-4211
Mailing address:
  • Phone: 512-443-3436
  • Fax: 512-445-4211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number143070
License Number StateTX

VIII. Authorized Official

Name: MICHAEL T. BERG
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 505-468-4752