Healthcare Provider Details

I. General information

NPI: 1477695641
Provider Name (Legal Business Name): EASTLAND MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 US HIGHWAY 80 E
MESQUITE TX
75150-5510
US

IV. Provider business mailing address

2231 US HIGHWAY 80 E
MESQUITE TX
75150-5510
US

V. Phone/Fax

Practice location:
  • Phone: 972-279-3601
  • Fax: 972-613-4539
Mailing address:
  • Phone: 972-279-3601
  • Fax: 972-613-4539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. SOON E BURNAM
Title or Position: TREASURER
Credential:
Phone: 949-540-1249