Healthcare Provider Details

I. General information

NPI: 1235232596
Provider Name (Legal Business Name): LAREDO SPECIALTY HOSPITAL, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 E BUSTAMANTE ST
LAREDO TX
78041-5470
US

IV. Provider business mailing address

1024 N GALLOWAY AVE STE 102
MESQUITE TX
75149-2434
US

V. Phone/Fax

Practice location:
  • Phone: 956-753-5353
  • Fax:
Mailing address:
  • Phone: 972-216-2299
  • 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: DENISE KANN
Title or Position: VICE PRESIDENT AND SECRETARY
Credential:
Phone: 972-216-2299