Organization
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
WHITEHALL REHAB & NURSING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID K BYROM (CEO)
(254) 248-6300
Entity
Organization
Contact information
Practice address
1116 E LOOP 304, CROCKETT, TX 75835-1810
(936) 544-2163
(936) 546-5454
Mailing address
1116 E LOOP 304, CROCKETT, TX 75835-1810
(936) 544-2163
(936) 546-5454
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004428
—
TX
Enumeration date
02/27/2017
Last updated
02/27/2017
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