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Organization
VICTORIA OF TEXAS LP
Active
Organization
VICTORIA OF TEXAS LP
Active
Parent organization
VICTORIA OF TEXAS LP
Other names
DeTar Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
VICTORIA OF TEXAS LP
Authorized official
LAURIE HOLTSFORD (AUTHORIZED OFFICIAL)
(615) 465-7466
Entity
Organization
Contact information
Practice address
506 E SAN ANTONIO ST, VICTORIA, TX 77901-6060
(361) 575-7441
(361) 788-6114
Mailing address
PO BOX 2089, VICTORIA, TX 77902-2089
(361) 575-7441
(361) 788-6114
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094118901
—
TX
Enumeration date
10/07/2009
Last updated
10/07/2009
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