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General NPI Number Information
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NPI Number | 1700885076
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Entity Type | Organization
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Legal Business Name | TH HEALTHCARE, LTD
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 4920 NE STALLINGS DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965-1254
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Country | US
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Telephone | 936-569-9481
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Fax | 936-568-3400
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Provider Business Mailing Address
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Address Line | PO BOX 849788
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City | DALLAS
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State | TX
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Zip | 75284-9788
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Country | US
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Telephone | 936-569-9481
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Fax | 936-568-3400
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Authorized Official
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Title or Position | CFO
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Name | RANDY SLACK
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Credential |
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Telephone | 936-568-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 392
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License Number State | TX
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