Healthcare Provider Details

I. General information

NPI: 1851752729
Provider Name (Legal Business Name): EASTLAND MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WESTPARK WAY
EULESS TX
76040-3977
US

IV. Provider business mailing address

900 WESTPARK WAY
EULESS TX
76040-3977
US

V. Phone/Fax

Practice location:
  • Phone: 817-545-4071
  • Fax: 908-455-0472
Mailing address:
  • Phone: 817-545-4071
  • Fax: 908-455-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: TREASURER
Credential:
Phone: 949-540-1249