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General NPI Number Information
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NPI Number | 1275405516
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Entity Type | Organization
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Legal Business Name | MAVERICK COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 4900 E SAM HOUSTON PKWY S
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City | PASADENA
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State | TX
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Zip | 77505-1400
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Country | US
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Telephone | 281-998-0399
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 E SAM HOUSTON PKWY S
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City | PASADENA
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State | TX
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Zip | 77505-1400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INTERIM CEO
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Name | NESTOR DANIEL BONILLA
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Credential |
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Telephone | 830-757-4990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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