Healthcare Provider Details

I. General information

NPI: 1275916090
Provider Name (Legal Business Name): WEST WHARTON COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1884 LOOP 343 WEST
RUSK TX
75785-2817
US

IV. Provider business mailing address

4150 INTERNATIONAL PLAZA SUITE 600
FORT WORTH TX
76109-4831
US

V. Phone/Fax

Practice location:
  • Phone: 903-683-1042
  • Fax: 903-683-3834
Mailing address:
  • Phone: 817-348-8959
  • Fax: 817-348-0466

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: MR. DAVID MAK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 979-578-5250