Healthcare Provider Details

I. General information

NPI: 1174109938
Provider Name (Legal Business Name): EASTLAND MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W BRITISH FLYING SCHOOL BLVD
TERRELL TX
75160-0043
US

IV. Provider business mailing address

250 W BRITISH FLYING SCHOOL BLVD
TERRELL TX
75160-0043
US

V. Phone/Fax

Practice location:
  • Phone: 972-551-0122
  • Fax: 972-551-3307
Mailing address:
  • Phone: 972-551-0122
  • Fax: 972-551-3307

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: SOON BURNAM
Title or Position: TREASURER OF MANAGEMENT COMPANY
Credential:
Phone: 949-540-1249