Healthcare Provider Details

I. General information

NPI: 1003061821
Provider Name (Legal Business Name): SOUTH LIMESTONE HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15015 CYPRESS WOODS MEDICAL DR
HOUSTON TX
77014-1461
US

IV. Provider business mailing address

1500 WATERS RIDGE DR STE. 200
LEWISVILLE TX
75057-6011
US

V. Phone/Fax

Practice location:
  • Phone: 281-586-6088
  • Fax: 281-586-6071
Mailing address:
  • Phone: 972-899-4401
  • Fax: 972-899-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number128310
License Number StateTX

VIII. Authorized Official

Name: LARRY PRICE
Title or Position: CEO
Credential:
Phone: 254-729-2689