Provider Demographics
NPI:1942643804
Name:NEW SAN ANTONIO SPECIALTY HOSPITAL LLC
Entity Type:Organization
Organization Name:NEW SAN ANTONIO SPECIALTY HOSPITAL LLC
Other - Org Name:LIFECARE HOSPITALS OF SAN ANTONIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT - REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-241-2128
Mailing Address - Street 1:5340 LEGACY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3178
Mailing Address - Country:US
Mailing Address - Phone:469-241-2128
Mailing Address - Fax:469-241-2177
Practice Address - Street 1:8902 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1681
Practice Address - Country:US
Practice Address - Phone:210-690-7000
Practice Address - Fax:210-690-7128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008528282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX452059Medicare Oscar/Certification