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Organization
STEPHENS MEMORIAL HOSPITAL DISTRICT
Active
Organization
STEPHENS MEMORIAL HOSPITAL DISTRICT
Active
Other names
Park Village Healthcare and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (AUTHORIZED AGENT)
(949) 540-1249
Entity
Organization
Contact information
Practice address
207 E PARKERVILLE RD, DESOTO, TX 75115-6251
(972) 230-1000
(972) 230-5509
Mailing address
207 E PARKERVILLE RD, DESOTO, TX 75115-6251
(972) 230-1000
(972) 230-5509
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
111200
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5257
—
TX
Enumeration date
09/08/2005
Last updated
10/11/2021
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