Provider Demographics
NPI:1811018286
Name:MAVERICK COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MAVERICK COUNTY HOSPITAL DISTRICT
Other - Org Name:PLEASANTON NORTH NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-757-4939
Mailing Address - Street 1:404 W GOODWIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4002
Mailing Address - Country:US
Mailing Address - Phone:830-569-2138
Mailing Address - Fax:
Practice Address - Street 1:404 W GOODWIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-4002
Practice Address - Country:US
Practice Address - Phone:830-569-2138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001012920Medicaid
TX001012920Medicaid