Healthcare Provider Details

I. General information

NPI: 1235392192
Provider Name (Legal Business Name): ACUITY HOSPITAL OF SOUTH TEXAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 LEXINGTON AVE
SAN ANTONIO TX
78212-4768
US

IV. Provider business mailing address

10735 DAVID TAYLOR DR STE 200
CHARLOTTE NC
28262-1060
US

V. Phone/Fax

Practice location:
  • Phone: 210-308-0261
  • Fax:
Mailing address:
  • Phone: 704-887-7283
  • Fax: 704-887-7283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number100050
License Number StateTX

VIII. Authorized Official

Name: STEPHEN CLAYTON
Title or Position: VP, REVENUE CYCLE
Credential:
Phone: 704-887-7283