Organization
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
FT WORTH SOUTHWEST NURSING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID K BYROM (CEO)
(254) 248-6300
Entity
Organization
Contact information
Practice address
5300 ALTAMESA BLVD, FORT WORTH, TX 76133-5924
(817) 346-1800
(817) 346-0149
Mailing address
5300 ALTAMESA BLVD, FORT WORTH, TX 76133-5924
(817) 346-1800
(817) 346-0149
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005197
—
TX
Enumeration date
01/14/2015
Last updated
01/23/2021
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