Healthcare Provider Details

I. General information

NPI: 1013957836
Provider Name (Legal Business Name): SHERMAN GRAYSON HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N HIGHLAND AVE
SHERMAN TX
75092-7354
US

IV. Provider business mailing address

500 N. HIGHLAND AVENUE
SHERMAN TX
75092-7354
US

V. Phone/Fax

Practice location:
  • Phone: 903-870-4611
  • Fax: 903-891-2030
Mailing address:
  • Phone: 903-870-4611
  • Fax: 903-891-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. KITTY RICHARDSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 903-870-4615