MEDICARE: GUADALUPE COUNTY HOSPITAL BOARD

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	314000000X	Skilled Nursing Facility		TX

General Provider Information

NPI Number	:	1801257779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUADALUPE COUNTY HOSPITAL BOARD

Provider Business Mailing Address
First Line	:	18514 SONTERRA PL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4263
Country	:	US
Telephone Number	:	210-545-4800
Fax Number	:	210-679-4950

Provider Business Practice Location Address
First Line	:	18514 SONTERRA PL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4263
Country	:	US
Telephone Number	:	210-545-4800
Fax Number	:	210-679-4950

Authorized Official
Title or Position	:	SECRETARY
Name	:	SOON BURNAM
Credential	:
Telephone Number	:	949-540-1249

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	04/07/2026

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