MEDICARE: FANNIN COUNTY HOSPITAL AUTHORITY

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

General Provider Information

NPI Number	:	1902132301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FANNIN COUNTY HOSPITAL AUTHORITY

Provider Business Mailing Address
First Line	:	812 W HOUSTON AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-2832
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 W HOUSTON AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-2832
Country	:	US
Telephone Number	:	956-682-6331
Fax Number	:

Authorized Official
Title or Position	:	TREASURER OF MANAGEMENT COMPANY
Name	:	SOON BURNAM
Credential	:
Telephone Number	:	949-540-1249

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	12/08/2023

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Directions to “FANNIN COUNTY HOSPITAL AUTHORITY ” Practice Location

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