MEDICARE: PLAZA SPECIALTY HOSPITAL, LLC

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

General Provider Information

NPI Number	:	1083143747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAZA SPECIALTY HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	2200 ROSS AVE STE 5400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-7918
Country	:	US
Telephone Number	:	469-621-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 BINZ ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-7016
Country	:	US
Telephone Number	:	713-285-1000
Fax Number	:	713-285-1001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRAD EUGENE HOLLINGER
Credential	:
Telephone Number	:	717-591-5700

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	09/06/2023

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