Provider Demographics
NPI:1154546836
Name:NOCONA HOSPITAL DISTRICT
Entity type:Organization
Organization Name:NOCONA HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND CHIEF FINANCIAL
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-303-9000
Mailing Address - Street 1:1413 E INTERSTATE 30 STE 7
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4598
Mailing Address - Country:US
Mailing Address - Phone:972-303-9000
Mailing Address - Fax:972-303-9992
Practice Address - Street 1:910 MIDWESTERN PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2210
Practice Address - Country:US
Practice Address - Phone:940-767-5500
Practice Address - Fax:940-235-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001026671Medicaid
TX001015058Medicaid
TX001015058Medicaid
TX6051930001Medicare NSC