Provider Demographics
NPI:1720490311
Name:WINNIE-STOWELL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:WINNIE-STOWELL HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-296-1003
Mailing Address - Street 1:607 W AVENUE B
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-1553
Mailing Address - Country:US
Mailing Address - Phone:254-547-1033
Mailing Address - Fax:254-542-3506
Practice Address - Street 1:607 W AVENUE B
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-1553
Practice Address - Country:US
Practice Address - Phone:254-547-1033
Practice Address - Fax:254-542-3506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-30
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5154314000000X
TX001025969314000000X
TX455515314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001025969Medicaid
TX5154Medicaid