Healthcare Provider Details

I. General information

NPI: 1306875281
Provider Name (Legal Business Name): SEMINOLE HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 NORTH MAIN STREET
SAN ANGELO TX
76903-4077
US

IV. Provider business mailing address

P.O. BOX 5661 902 NORTH MAIN STREET
SAN ANGELO TX
76903-4077
US

V. Phone/Fax

Practice location:
  • Phone: 325-655-7391
  • Fax: 325-653-1413
Mailing address:
  • Phone: 325-655-7391
  • Fax: 325-653-1413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number116542
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number129631
License Number StateTX

VIII. Authorized Official

Name: QUINDA FEIL-DUNCAN
Title or Position: VICE-PRESIDENT
Credential: LNFA
Phone: 325-655-7391