Provider Demographics
NPI:1912906298
Name:SOUTHWEST GENERAL HOSPITAL LP
Entity Type:Organization
Organization Name:SOUTHWEST GENERAL HOSPITAL LP
Other - Org Name:TEXAS VISTA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-341-8804
Mailing Address - Street 1:7400 BARLITE BLVD
Mailing Address - Street 2:ATTN: BILLING
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1308
Mailing Address - Country:US
Mailing Address - Phone:210-921-2000
Mailing Address - Fax:210-921-3508
Practice Address - Street 1:7400 BARLITE BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1308
Practice Address - Country:US
Practice Address - Phone:210-921-2000
Practice Address - Fax:210-921-3508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136491101Medicaid
TX136491107Medicaid
TX136491108Medicaid
TX136491104Medicaid
TX136491102Medicaid
TX136491110Medicaid
TX136491106Medicaid
TX136491108Medicaid