# CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** FT WORTH SOUTHWEST NURSING CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023407012
- **Authorized official:** DAVID K BYROM (CEO)
- **Authorized official phone:** (254) 248-6300

## Contact information

- **Practice address:** 5300 ALTAMESA BLVD, FORT WORTH, TX 76133-5924
- **Practice address phone:** (817) 346-1800
- **Practice address fax:** (817) 346-0149
- **Mailing address:** 5300 ALTAMESA BLVD, FORT WORTH, TX 76133-5924
- **Mailing address phone:** (817) 346-1800
- **Mailing address fax:** (817) 346-0149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2015
- **Last updated:** 01/23/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005197 | — | TX |