# WEST WHARTON COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Specialty Rehab & Nursing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841563038
- **Authorized official:** MR. DAVID MAK (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (979) 578-5250

## Contact information

- **Practice address:** 4320 WEST 19TH STREET, LUBBOCK, TX 79407-2407
- **Practice address phone:** (806) 795-1774
- **Practice address fax:** (806) 771-3868
- **Mailing address:** 4150 INTERNATIONAL PLAZA, SUITE 600, FORT WORTH, TX 76109-4831
- **Mailing address phone:** (817) 348-8959
- **Mailing address fax:** (817) 348-0466

## Taxonomy

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

## Other

- **Enumeration date:** 02/17/2012
- **Last updated:** 02/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001020268 | — | TX |
| 01 | — | 004235 | FACILITY ID | TX |