Healthcare Provider Details

I. General information

NPI: 1265898985
Provider Name (Legal Business Name): GUADALUPE COUNTY HOSPITAL BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SCENIC DR
GEORGETOWN TX
78626-7725
US

IV. Provider business mailing address

2001 SCENIC DR
GEORGETOWN TX
78626-7725
US

V. Phone/Fax

Practice location:
  • Phone: 512-863-9511
  • Fax:
Mailing address:
  • Phone: 512-863-9511
  • Fax:

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: PENNY WALLACE
Title or Position: CFO
Credential:
Phone: 830-401-7220