=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306849153
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILSON COUNTY MEMORIAL HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2005
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1303 HOSPITAL BLVD
-----------------------------------------------------
City | FLORESVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78114-2731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-393-1540
-----------------------------------------------------
Fax | 830-393-1550
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1303 HOSPITAL BLVD
-----------------------------------------------------
City | FLORESVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78114-2731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-393-1540
-----------------------------------------------------
Fax | 830-393-1550
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ALTERNATE ADMINISTRATOR
-----------------------------------------------------
Name | MS. NYDIA GARCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 830-393-1544
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 002830
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------