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NPI Code Detail

MEDICARE: MAVERICK COUNTY HOSPITAL DISTRICT

MEDICARE: MAVERICK COUNTY HOSPITAL DISTRICT
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1275405516
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAVERICK COUNTY HOSPITAL DISTRICT
Provider Business Mailing Address
First Line : 4900 E SAM HOUSTON PKWY S
Second Line :
City : PASADENA
State : TX
Zip : 77505-1400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4900 E SAM HOUSTON PKWY S
Second Line :
City : PASADENA
State : TX
Zip : 77505-1400
Country : US
Telephone Number : 281-998-0399
Fax Number :
Authorized Official
Title or Position : INTERIM CEO
Name : NESTOR DANIEL BONILLA
Credential :
Telephone Number : 830-757-4990
Provider Enumeration Date : 09/17/2025
Last Update Date : 12/05/2025

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Directions to “MAVERICK COUNTY HOSPITAL DISTRICT ” Practice Location

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