Provider Demographics
NPI:1699763136
Name:SWEENY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:SWEENY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-548-1598
Mailing Address - Street 1:305 N MCKINNEY ST
Mailing Address - Street 2:
Mailing Address - City:SWEENY
Mailing Address - State:TX
Mailing Address - Zip Code:77480-2801
Mailing Address - Country:US
Mailing Address - Phone:979-548-1598
Mailing Address - Fax:979-548-1595
Practice Address - Street 1:413 GARLAND DR
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-6240
Practice Address - Country:US
Practice Address - Phone:979-297-3266
Practice Address - Fax:979-297-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005139OtherFACILITY ID NO.
TX005139OtherFACILITY ID NO.
TX1248470050Medicare NSC
TX005139OtherFACILITY ID NO.