Provider Demographics
NPI:1376306944
Name:BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BALLINGER MEMORIAL HOSPITAL DISTRICT
Other - Org Name:PARK PLAZA NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRICKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-365-2531
Mailing Address - Street 1:4150 INTERNATIONAL PLAZA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4875
Mailing Address - Country:US
Mailing Address - Phone:817-348-8959
Mailing Address - Fax:817-348-0466
Practice Address - Street 1:2210 HOWARD STREET
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-1318
Practice Address - Country:US
Practice Address - Phone:325-944-0561
Practice Address - Fax:325-944-0562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility