Healthcare Provider Details

I. General information

NPI: 1851720452
Provider Name (Legal Business Name): FANNIN COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 N EDWARDS AVE
MT PLEASANT TX
75455-2010
US

IV. Provider business mailing address

5300 W SAM HOUSTON PKWY N SUITE 100
HOUSTON TX
77041-5161
US

V. Phone/Fax

Practice location:
  • Phone: 903-572-5511
  • Fax:
Mailing address:
  • Phone: 903-572-5511
  • 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: KELLE C SANTORO
Title or Position: SR DIRECTOR AR
Credential:
Phone: 832-467-5728