Healthcare Provider Details

I. General information

NPI: 1659763795
Provider Name (Legal Business Name): VAL VERDE COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RIVERSIDE DR
UVALDE TX
78801-5727
US

IV. Provider business mailing address

PO BOX 7230
VICTORIA TX
77903-7230
US

V. Phone/Fax

Practice location:
  • Phone: 830-278-5641
  • Fax: 830-278-5361
Mailing address:
  • Phone: 361-576-9454
  • Fax: 361-576-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number139516
License Number StateTX

VIII. Authorized Official

Name: MR. MICHAEL W WHITLEY
Title or Position: MANAGER
Credential:
Phone: 361-576-9454