MEDICARE: NEXUS SPECIALTY HOSPITAL - THE WOODLANDS, LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282E00000X	Long Term Care Hospital	000795	TX
2	283X00000X	Rehabilitation Hospital
3	284300000X	Special Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HH0931	OTHER	TX	BLUECROSS

General Provider Information

NPI Number	:	1023069697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXUS SPECIALTY HOSPITAL - THE WOODLANDS, LTD.

Provider Business Mailing Address
First Line	:	1 RIVERWAY STE 700
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-1988
Country	:	US
Telephone Number	:	713-355-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 VISION PARK BLVD
Second Line	:
City	:	SHENANDOAH
State	:	TX
Zip	:	77384-3001
Country	:	US
Telephone Number	:	281-364-0317
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. ERIN LEIGH CASSIDY
Credential	:
Telephone Number	:	713-355-6111

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/13/2021

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