Provider Demographics
NPI:1659440634
Name:TRANSITIONAL HOSPITALS CORPORATION OF TEXAS, LLC
Entity Type:Organization
Organization Name:TRANSITIONAL HOSPITALS CORPORATION OF TEXAS, LLC
Other - Org Name:KINDRED HOSPITAL - TARRANT COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-253-5121
Mailing Address - Street 1:7800 OAKMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4203
Mailing Address - Country:US
Mailing Address - Phone:817-346-0094
Mailing Address - Fax:817-263-4071
Practice Address - Street 1:7800 OAKMONT BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132
Practice Address - Country:US
Practice Address - Phone:817-346-0094
Practice Address - Fax:817-263-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000800282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX452028OtherSECURE HORIZONS
TXHH0920OtherBLUE CROSS
TX452028OtherGREAT WEST
TX021011401Medicaid
TX=========OtherHUMANA
TXHH0920OtherBLUE CROSS
TX021011401Medicaid
TX=========OtherPACIFICARE
TX=========OtherTRICARE CHAMPUS
TX=========OtherUNITED HEALTHCARE
TX452028OtherSECURE HORIZONS