# SOUTHLAKE SPECIALTY HOSPITAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Texas Health Harris Methodist Hospital Southlake
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629064928
- **Authorized official:** MRS. TRACI BERNARD (PRESIDENT)
- **Authorized official phone:** (817) 748-8784

## Contact information

- **Practice address:** 1545 SOUTHLAKE BLVD., SOUTHLAKE, TX 76092-6422
- **Practice address phone:** (817) 748-8784
- **Practice address fax:** (817) 748-8787
- **Mailing address:** PO BOX 735801, DALLAS, TX 75373-5801
- **Mailing address phone:** (972) 419-6704
- **Mailing address fax:** (972) 419-8118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 008128 | TX | Yes |

## Other

- **Enumeration date:** 09/22/2005
- **Last updated:** 02/18/2025