Healthcare Provider Details

I. General information

NPI: 1053511980
Provider Name (Legal Business Name): DEWITT MEDICAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 TULL DR
KATY TX
77449-5099
US

IV. Provider business mailing address

1525 TULL DR
KATY TX
77449-5099
US

V. Phone/Fax

Practice location:
  • Phone: 281-578-1600
  • Fax: 281-829-3562
Mailing address:
  • Phone: 281-578-1600
  • Fax: 281-829-3562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number114213
License Number StateTX

VIII. Authorized Official

Name: ALMA ALEXANDER
Title or Position: CFO
Credential:
Phone: 361-275-6191