MEDICARE: WINNIE-STOWELL 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
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851938112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINNIE-STOWELL HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1780 HUGHES LANDING BLVD STE 500
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-4009
Country	:	US
Telephone Number	:	281-419-5520
Fax Number	:	281-419-5527

Provider Business Practice Location Address
First Line	:	227 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1238
Country	:	US
Telephone Number	:	936-564-4596
Fax Number	:	936-715-0376

Authorized Official
Title or Position	:	BOARD PRESIDENT
Name	:	EDWARD MURRELL
Credential	:
Telephone Number	:	409-296-1003

Provider Enumeration Date	:	12/05/2019
Last Update Date	:	06/14/2021

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