Provider Demographics
NPI:1467490599
Name:NAVARRO HOSPITAL LP
Entity Type:Organization
Organization Name:NAVARRO HOSPITAL LP
Other - Org Name:NAVARRO REGIONAL HOSPITAL SNF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:PO BOX 847488
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7488
Mailing Address - Country:US
Mailing Address - Phone:903-654-6800
Mailing Address - Fax:903-654-6955
Practice Address - Street 1:3201 W HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2450
Practice Address - Country:US
Practice Address - Phone:903-654-6800
Practice Address - Fax:903-654-6955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVARRO HOSPITAL LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000141314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001001185Medicaid
675376Medicare Oscar/Certification