Provider Demographics
NPI:1619123908
Name:ROCKWALL REGIONAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:ROCKWALL REGIONAL HOSPITAL, LLC
Other - Org Name:TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM PRESIDENT/CFO/COO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LINSCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:469-698-1502
Mailing Address - Street 1:PO BOX 676868
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-6868
Mailing Address - Country:US
Mailing Address - Phone:972-419-6704
Mailing Address - Fax:972-419-8118
Practice Address - Street 1:3150 HORIZON RD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7805
Practice Address - Country:US
Practice Address - Phone:469-698-1000
Practice Address - Fax:469-698-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008599282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193399602Medicaid