Provider Demographics
NPI:1265653281
Name:CHG CORNERSTONE HOSPITAL OF CENTRAL TEXAS, L.P.
Entity Type:Organization
Organization Name:CHG CORNERSTONE HOSPITAL OF CENTRAL TEXAS, L.P.
Other - Org Name:CHG CORNERSTONE HOSPITAL OF CENTRAL TEXAS AT SOUTH AUSTIN HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-621-6715
Mailing Address - Street 1:13455 NOEL RD
Mailing Address - Street 2:SUITE 1320
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6620
Mailing Address - Country:US
Mailing Address - Phone:469-621-6700
Mailing Address - Fax:469-621-6672
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:3RD FLOOR NE
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6903
Practice Address - Country:US
Practice Address - Phone:512-706-1900
Practice Address - Fax:512-706-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008281282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1831521-01Medicaid
TX1831521-01Medicaid