Provider Demographics
NPI:1457024044
Name:GUADALUPE COUNTY HOSPITAL BOARD
Entity Type:Organization
Organization Name:GUADALUPE COUNTY HOSPITAL BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:8324 CAMERON RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-3990
Mailing Address - Country:US
Mailing Address - Phone:737-241-0800
Mailing Address - Fax:737-241-0801
Practice Address - Street 1:8324 CAMERON RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-3990
Practice Address - Country:US
Practice Address - Phone:737-241-0800
Practice Address - Fax:737-241-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility