Basic Information
| Provider Information | |||||||||
| NPI: | 1164989158 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEWARD TEXAS HOSPITAL HOLDINGS LLC | ||||||||
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| OtherOrganizationName: | SCENIC MOUNTAIN MEDICAL CENTER, A STEWARD FAMILY HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N PEARL ST STE 2400 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752012470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4693418800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 W 11TH PL | ||||||||
| Address2: | |||||||||
| City: | BIG SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797204114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4322631211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2019 | ||||||||
| LastUpdateDate: | 06/24/2019 | ||||||||
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| AuthorizedOfficialLastName: | KRABILL | ||||||||
| AuthorizedOfficialFirstName: | EMMA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4322684903 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | STEWARD TEXAS HOSPITAL HOLDINGS LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | Y | Hospital Units | Medicare Defined Swing Bed Unit |
No ID Information.