Healthcare Provider Details

I. General information

NPI: 1639535131
Provider Name (Legal Business Name): TYLER COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W PARK
LIVINGSTON TX
77351-8151
US

IV. Provider business mailing address

1100 W BLUFF ST
WOODVILLE TX
75979-4738
US

V. Phone/Fax

Practice location:
  • Phone: 936-328-5021
  • Fax: 936-328-5022
Mailing address:
  • Phone: 409-283-6400
  • Fax: 409-283-5961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number142698
License Number StateTX

VIII. Authorized Official

Name: DR. SANDRA GAYLE WRIGHT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: RN, ED.D
Phone: 409-283-4600