Healthcare Provider Details

I. General information

NPI: 1336543081
Provider Name (Legal Business Name): DECATUR HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2014
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 IRA E. WOODS PARKWAY
GRAPEVINE TX
76051-4018
US

IV. Provider business mailing address

1005 IRA E. WOODS PARKWAY
GRAPEVINE TX
76051-4018
US

V. Phone/Fax

Practice location:
  • Phone: 817-421-1313
  • Fax:
Mailing address:
  • Phone: 817-421-1313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRIAN TODD SCROGGINS
Title or Position: CEO
Credential:
Phone: 940-900-4348