Provider Demographics
NPI:1518355759
Name:TEXAS HEALTH HUGULEY, INC
Entity Type:Organization
Organization Name:TEXAS HEALTH HUGULEY, INC
Other - Org Name:TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, REGIONAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-551-2740
Mailing Address - Street 1:PO BOX 6452
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0452
Mailing Address - Country:US
Mailing Address - Phone:817-551-2721
Mailing Address - Fax:817-568-5545
Practice Address - Street 1:11801 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7021
Practice Address - Country:US
Practice Address - Phone:817-293-9110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100157273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit