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General NPI Number Information
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NPI Number | 1730278417
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Entity Type | Organization
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Legal Business Name | TEXAS HEALTH SPECIALTY HOSPITAL FORT WORTH
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 1301 PENNSYLVANIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-2122
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Country | US
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Telephone | 817-882-3770
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Fax | 817-570-8199
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Provider Business Mailing Address
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Address Line | 500 E BORDER ST # 124
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City | ARLINGTON
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State | TX
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Zip | 76010-7445
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Country | US
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Telephone | 800-890-6034
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Fax |
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Authorized Official
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Title or Position | SENIOR VP REVENUE CYCLE
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Name | JEFF MINCHER
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Credential |
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Telephone | 682-236-3013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | 000652
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License Number State | TX
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