Provider Demographics
NPI:1275922452
Name:UVALDE COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:UVALDE COUNTY HOSPITAL AUTHORITY
Other - Org Name:LAREDO NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:NORDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-278-6251
Mailing Address - Street 1:1025 GARNER FIELD RD
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4809
Mailing Address - Country:US
Mailing Address - Phone:830-278-6251
Mailing Address - Fax:830-278-8529
Practice Address - Street 1:1701 TOURNAMENT TRAIL DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6564
Practice Address - Country:US
Practice Address - Phone:956-727-3422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676313Medicare Oscar/Certification