Provider Demographics
NPI:1053511980
Name:DEWITT MEDICAL DISTRICT
Entity Type:Organization
Organization Name:DEWITT MEDICAL DISTRICT
Other - Org Name:OAKMONT HEALTHCARE & REHABILITATION CENTER OF KATY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEISHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-771-7575
Mailing Address - Street 1:1525 TULL DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-5099
Mailing Address - Country:US
Mailing Address - Phone:281-578-1600
Mailing Address - Fax:281-829-3562
Practice Address - Street 1:1525 TULL DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-5099
Practice Address - Country:US
Practice Address - Phone:281-578-1600
Practice Address - Fax:281-829-3562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114213314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001031636Medicaid
TX001015231Medicaid