Healthcare Provider Details

I. General information

NPI: 1063006971
Provider Name (Legal Business Name): MAVERICK COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 03/20/2022
Certification Date: 03/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S MAIN ST
LOCKHART TX
78644-3945
US

IV. Provider business mailing address

1501 S MAIN ST
LOCKHART TX
78644-3945
US

V. Phone/Fax

Practice location:
  • Phone: 512-398-2362
  • Fax:
Mailing address:
  • Phone: 512-398-2362
  • 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: ALMA MARTINEZ
Title or Position: CEO
Credential:
Phone: 830-757-4939