profession roster report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020...

45
License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S Profession Roster Report Order By Name Hospitals LIC# Selected Address(MA) Phone Status/Secondary Status Expires Rank Date Status Date Orig. Date Name ACCEL REHABILITATION HOSPITAL OF PLANO 100174 9728995510 2301 MARSH LANE SUITE 200 11/30/2022 11/29/2012 11/29/2012 03/16/2015 Current PLANO, TX 75093 AD HOSPITAL EAST LLC 100344 7133303887 12950 EAST FREEWAY SUITE 100 01/31/2022 01/21/2016 01/21/2016 05/06/2021 Current HOUSTON, TX 77015 ADVENTHEALTH BEHAVIORAL HEALTH CENTER 000397 2545198328 2407 SOUTH CLEAR CREEK ROAD 09/30/2022 09/01/1992 09/01/1992 09/01/1992 Current KILLEEN, TX 76549 ADVENTHEALTH CENTRAL TEXAS 000397 2545198165 2201 SOUTH CLEAR CREEK ROAD 09/30/2022 01/01/1960 01/01/1960 12/28/2018 Current KILLEEN, TX 76549 ADVENTHEALTH ROLLINS BROOK 007209 5125563682 608 NORTH KEY AVENUE 08/31/2022 08/18/2000 08/18/2000 01/10/2019 Current LAMPASAS, TX 76550 ALTUS BAYTOWN HOSPITAL, BAYTOWN MEDICAL CENTER 100254 2818377600 1626 W BAKER RD 04/30/2022 04/09/2014 04/09/2014 09/24/2020 Current BAYTOWN, TX 77521 ALTUS HOUSTON HOSPITAL, CELESTIAL HOSPITAL, ODYSSEY HOSPITAL 100407 7137730556 6011 W SAM HOUSTON PKWY SOUTH 11/30/2021 11/03/2017 11/03/2017 11/03/2017 Current HOUSTON, TX 77072 ANSON GENERAL HOSPITAL 100346 3258233231 101 AVENUE J 03/31/2022 04/01/2016 04/01/2016 04/01/2016 Current ANSON, TX 79501 ARISE AUSTIN MEDICAL CENTER 100216 5123143800 3003 BEE CAVE ROAD 06/30/2023 06/30/2013 06/30/2013 06/03/2021 Current AUSTIN, TX 78746 ASCENSION PROVIDENCE 000040 2547514000 6901 MEDICAL PARKWAY 03/31/2023 01/01/1960 01/01/1960 03/01/2019 Current WACO, TX 76712 ASCENSION PROVIDENCE DEPAUL CENTER 000040 2547765970 301 LONDONDERRY DRIVE 03/31/2023 07/01/2010 07/01/2010 07/01/2010 Current WACO, TX 76712 ASCENSION SETON BASTROP 100497 7378817400 630 W SH 71 11/30/2021 11/25/2019 11/25/2019 11/25/2019 Current BASTROP, TX 78602 ASCENSION SETON EDGAR B DAVIS 000597 8308757000 130 HAYS STREET 01/31/2022 01/14/1966 01/14/1966 04/01/2019 Current LULING, TX 78648 ASCENSION SETON HAYS 100029 5125045058 6001 KYLE PARKWAY 08/31/2021 08/19/2009 08/19/2009 09/13/2019 Current KYLE, TX 78640 ASCENSION SETON HIGHLAND LAKES 000559 5127153000 3201 SOUTH WATER STREET 01/31/2022 02/13/1960 02/13/1960 04/01/2019 Current BURNET, TX 78611 Page 1 of 45 6/10/2021

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Page 1: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ACCEL REHABILITATION HOSPITAL OF

PLANO

100174 97289955102301 MARSH LANE SUITE 200 11/30/2022 11/29/2012 11/29/2012 03/16/2015 Current

PLANO, TX 75093

AD HOSPITAL EAST LLC100344 713330388712950 EAST FREEWAY SUITE 100 01/31/2022 01/21/2016 01/21/2016 05/06/2021 Current

HOUSTON, TX 77015

ADVENTHEALTH BEHAVIORAL

HEALTH CENTER

000397 25451983282407 SOUTH CLEAR CREEK ROAD 09/30/2022 09/01/1992 09/01/1992 09/01/1992 Current

KILLEEN, TX 76549

ADVENTHEALTH CENTRAL TEXAS000397 25451981652201 SOUTH CLEAR CREEK ROAD 09/30/2022 01/01/1960 01/01/1960 12/28/2018 Current

KILLEEN, TX 76549

ADVENTHEALTH ROLLINS BROOK007209 5125563682608 NORTH KEY AVENUE 08/31/2022 08/18/2000 08/18/2000 01/10/2019 Current

LAMPASAS, TX 76550

ALTUS BAYTOWN HOSPITAL,

BAYTOWN MEDICAL CENTER

100254 28183776001626 W BAKER RD 04/30/2022 04/09/2014 04/09/2014 09/24/2020 Current

BAYTOWN, TX 77521

ALTUS HOUSTON HOSPITAL,

CELESTIAL HOSPITAL, ODYSSEY

HOSPITAL

100407 71377305566011 W SAM HOUSTON PKWY SOUTH 11/30/2021 11/03/2017 11/03/2017 11/03/2017 Current

HOUSTON, TX 77072

ANSON GENERAL HOSPITAL100346 3258233231101 AVENUE J 03/31/2022 04/01/2016 04/01/2016 04/01/2016 Current

ANSON, TX 79501

ARISE AUSTIN MEDICAL CENTER100216 51231438003003 BEE CAVE ROAD 06/30/2023 06/30/2013 06/30/2013 06/03/2021 Current

AUSTIN, TX 78746

ASCENSION PROVIDENCE000040 25475140006901 MEDICAL PARKWAY 03/31/2023 01/01/1960 01/01/1960 03/01/2019 Current

WACO, TX 76712

ASCENSION PROVIDENCE DEPAUL

CENTER

000040 2547765970301 LONDONDERRY DRIVE 03/31/2023 07/01/2010 07/01/2010 07/01/2010 Current

WACO, TX 76712

ASCENSION SETON BASTROP100497 7378817400630 W SH 71 11/30/2021 11/25/2019 11/25/2019 11/25/2019 Current

BASTROP, TX 78602

ASCENSION SETON EDGAR B DAVIS000597 8308757000130 HAYS STREET 01/31/2022 01/14/1966 01/14/1966 04/01/2019 Current

LULING, TX 78648

ASCENSION SETON HAYS100029 51250450586001 KYLE PARKWAY 08/31/2021 08/19/2009 08/19/2009 09/13/2019 Current

KYLE, TX 78640

ASCENSION SETON HIGHLAND LAKES000559 51271530003201 SOUTH WATER STREET 01/31/2022 02/13/1960 02/13/1960 04/01/2019 Current

BURNET, TX 78611

Page 1 of 456/10/2021

Page 2: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ASCENSION SETON MEDICAL CENTER

AUSTIN

000497 51232410001201 WEST 38TH STREET 03/31/2022 01/18/1960 01/18/1960 04/10/2019 Current

AUSTIN, TX 78705

ASCENSION SETON NORTHWEST007976 512324690011113 RESEARCH BOULEVARD 06/30/2023 07/01/2003 07/01/2003 04/01/2019 Current

AUSTIN, TX 78759

ASCENSION SETON SMITHVILLE100103 51223732141201 HILL ROAD 06/30/2023 06/27/2011 07/26/2011 04/01/2019 Current

SMITHVILLE, TX 78957

ASCENSION SETON SOUTHWEST007975 51232490007900 FM 1826 06/30/2022 07/01/2003 07/01/2003 05/14/2020 Current

AUSTIN, TX 78737

ASCENSION SETON WILLIAMSON008617 5123244000201 SETON PARKWAY 01/31/2022 01/15/2008 01/15/2008 04/01/2019 Current

ROUND ROCK, TX 78665

ASPIRE HOSPITAL LLC100173 93664735002006 SOUTH LOOP 336 WEST SUITE

500

11/30/2022 11/16/2012 11/16/2012 10/14/2020 Current

CONROE, TX 77304

ATRIUM MEDICAL CENTER LP100026 281207820011929 WEST AIRPORT BOULEVARD 12/31/2022 12/31/2008 12/31/2008 12/29/2020 Current

STAFFORD, TX 77477

BALLINGER MEMORIAL HOSPITAL

DISTRICT

000234 3253652531608 AVENUE B 01/31/2023 12/01/1962 12/01/1962 01/04/2011 Current

BALLINGER, TX 76821

BAPTIST EMERGENCY HOSPITAL100116 210572291125615 NORTH US HIGHWAY 281 11/30/2021 12/14/2012 12/14/2012 10/23/2019 Current

SAN ANTONIO, TX 78258

BAPTIST EMERGENCY HOSPITAL100116 210402409216088 SAN PEDRO 11/30/2021 11/28/2011 11/28/2011 01/09/2020 Current

SAN ANTONIO, TX 78232

BAPTIST EMERGENCY HOSPITAL100116 210572091110811 TOWN CENTER DRIVE 11/30/2021 10/17/2012 10/17/2012 10/23/2019 Current

SAN ANTONIO, TX 78251

BAPTIST EMERGENCY HOSPITAL100116 21057229557719 IH 35 SOUTH 11/30/2021 10/31/2016 10/31/2016 10/31/2016 Current

SAN ANTONIO, TX 78224

BAPTIST EMERGENCY HOSPITAL100116 21057288858230 NORTH 1604 WEST 11/30/2021 02/13/2013 02/13/2013 10/23/2019 Current

SAN ANTONIO, TX 78249

BAPTIST EMERGENCY HOSPITAL100116 210571840016977 I-35 NORTH 11/30/2021 04/03/2013 04/03/2013 10/23/2019 Current

SCHERTZ, TX 78154

BAPTIST EMERGENCY HOSPITAL

(KELLY)

100116 7268002040806 CUPPLES ROAD 11/30/2021 01/09/2020 01/09/2020 01/09/2020 Current

SAN ANTONIO, TX 78237

BAPTIST HOSPITALS OF SOUTHEAST

TEXAS

000389 40921250003080 COLLEGE STREET 01/31/2022 10/01/1999 10/01/1999 01/03/2020 Current

Page 2 of 456/10/2021

Page 3: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BEAUMONT, TX 77701

BAPTIST HOSPITALS OF SOUTHEAST

TEXAS FANNIN BEHAVIORAL CENTER

000389 40921270003250 FANNIN 01/31/2022 10/01/1999 10/01/1999 09/21/2004 Current

BEAUMONT, TX 77701

BAPTIST MEDICAL CENTER000114 2102977600111 DALLAS STREET 12/31/2022 03/23/1960 03/23/1960 08/19/2019 Current

SAN ANTONIO, TX 78205

BAPTIST ST ANTHONYS HOSPITAL100187 80621220001600 WALLACE BLVD 01/31/2023 01/01/2013 01/01/2013 01/01/2013 Current

AMARILLO, TX 79106

BAYLOR SCOTT & WHITE

EMERGENCY HOSPITAL MANSFIELD

100258 21429463001776 NORTH US 287 SUITE 100 05/31/2022 07/09/2014 07/09/2014 07/09/2014 Current

MANSFIELD, TX 76063

BAYLOR SCOTT & WHITE ALL SAINTS

MEDICAL CENTER - FORT WORTH

000363 81792625441400 EIGHTH AVENUE 03/31/2022 01/01/1960 01/01/1960 05/18/2017 Current

FORT WORTH, TX 76104

BAYLOR SCOTT & WHITE CONTINUING

CARE HOSPITAL

008503 2542150900546 N KEGLEY RD 04/30/2023 04/23/2007 04/23/2007 09/24/2020 Current

TEMPLE, TX 76502

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL AUBREY

008732 972347252526791 HIGHWAY 380 12/31/2022 12/15/2008 12/15/2008 11/25/2020 Current

AUBREY, TX 76227

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL BURLESON

100258 214294625012500 SOUTH FREEWAY SUITE 100 05/31/2022 05/14/2014 05/14/2014 09/24/2018 Current

BURLESON, TX 76028

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL COLLEYVILLE

008732 21429463505500 COLLEYVILLE BOULEVARD 12/31/2022 07/22/2014 07/22/2014 11/25/2020 Current

COLLEYVILLE, TX 76034

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL GRAND PRAIRIE

100258 97285400093095 KINGSWOOD BOULEVARD SUITE

100

05/31/2022 10/06/2017 10/06/2017 10/06/2017 Current

GRAND PRAIRIE, TX 75052

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL KELLER

008732 2142946100620 SOUTH MAIN SUITE 100 12/31/2022 12/16/2013 12/16/2013 11/25/2020 Current

KELLER, TX 76248

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL MURPHY

008732 2142946150511 FM 544 SUITE 100 12/31/2022 01/09/2014 01/09/2014 11/25/2020 Current

MURPHY, TX 75094

BAYLOR SCOTT & WHITE EMERGENCY

HOSPITAL ROCKWALL

008732 21429462001975 ALPHA SUITE 100 12/31/2022 04/10/2018 04/10/2018 04/10/2018 Current

ROCKWALL, TX 75087

Page 3 of 456/10/2021

Page 4: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BAYLOR SCOTT & WHITE EMERGENCY

MEDICAL CENTER - CEDAR PARK

008526 5126844000900 E WHITESTONE BLVD 07/31/2021 07/01/2019 07/01/2019 07/01/2019 Current

CEDAR PARK, TX 78613

BAYLOR SCOTT & WHITE HEART AND

VASCULAR HOSPITAL - DALLAS

007844 2148200600621 NORTH HALL STREET 04/30/2023 04/19/2002 04/19/2002 04/22/2021 Current

DALLAS, TX 75226

BAYLOR SCOTT & WHITE INSTITUTE

FOR REHABILITATION

100092 2148209300909 NORTH WASHINGTON AVENUE 03/31/2023 03/01/2011 03/01/2011 01/11/2018 Current

DALLAS, TX 75246

BAYLOR SCOTT & WHITE INSTITUTE

FOR REHABILITATION - FORT WORTH

008738 81743396006601 HARRIS PARKWAY 12/31/2022 12/19/2008 12/19/2008 01/11/2018 Current

FORT WORTH, TX 76132

BAYLOR SCOTT & WHITE INSTITUTE

FOR REHABILITATION - FRISCO

100093 46988851002990 LEGACY DRIVE 03/31/2023 03/23/2011 03/23/2011 01/11/2018 Current

FRISCO, TX 75034

BAYLOR SCOTT & WHITE INSTITUTE

FOR REHABILITATION - LAKEWAY

100438 51226345002000 MEDICAL DRIVE 06/30/2022 06/26/2018 06/26/2018 06/26/2018 Current

LAKEWAY, TX 78734

BAYLOR SCOTT & WHITE MCLANE

CHILDRENS MEDICAL CENTER

000537 25477186001901 SW H K DODGEN LOOP 03/31/2022 09/23/2011 09/23/2011 03/23/2020 Current

TEMPLE, TX 76502

BAYLOR SCOTT & WHITE MEDICAL

CENTER - AUSTIN

100506 51265421005245 W HIGHWAY 290 01/31/2022 01/10/2020 01/10/2020 01/10/2020 Current

AUSTIN, TX 78735

BAYLOR SCOTT & WHITE MEDICAL

CENTER - BRENHAM

100098 9793375000700 MEDICAL PKWY 06/30/2022 07/01/2010 07/01/2010 11/23/2020 Current

BRENHAM, TX 77833

BAYLOR SCOTT & WHITE MEDICAL

CENTER - BUDA

100476 73799962005330 OVERPASS RD STE 110 08/31/2021 08/29/2019 08/29/2019 09/14/2020 Current

BUDA, TX 78610

BAYLOR SCOTT & WHITE MEDICAL

CENTER - CENTENNIAL

100421 469764914312505 LEBANON ROAD 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

FRISCO, TX 75035

BAYLOR SCOTT & WHITE MEDICAL

CENTER - COLLEGE STATION

100206 9792070100700 SCOTT & WHITE DRIVE 07/31/2021 07/12/2013 07/12/2013 02/12/2020 Current

COLLEGE STATION, TX 77845

BAYLOR SCOTT & WHITE MEDICAL

CENTER - FRISCO

007874 21440750005601 WARREN PARKWAY 08/31/2021 08/29/2002 08/29/2002 02/25/2016 Current

FRISCO, TX 75034

Page 4 of 456/10/2021

Page 5: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BAYLOR SCOTT & WHITE MEDICAL

CENTER - GRAPEVINE

000513 81748115881650 WEST COLLEGE STREET 08/31/2022 10/20/1967 10/20/1967 04/25/2016 Current

GRAPEVINE, TX 76051

BAYLOR SCOTT & WHITE MEDICAL

CENTER - HILLCREST

000506 2542029414100 HILLCREST MEDICAL BLV 02/28/2023 04/07/2009 04/07/2009 02/09/2017 Current

WACO, TX 76712

BAYLOR SCOTT & WHITE MEDICAL

CENTER - IRVING

000300 97257954091901 NORTH MACARTHUR

BOULEVARD

07/31/2021 11/15/1964 11/15/1964 07/26/2019 Current

IRVING, TX 75061

BAYLOR SCOTT & WHITE MEDICAL

CENTER - LAKE POINTE

008618 97252080006800 SCENIC DRIVE 01/31/2022 01/16/2008 01/16/2008 06/10/2019 Current

ROWLETT, TX 75088

BAYLOR SCOTT & WHITE MEDICAL

CENTER - LAKEWAY

008526 5125715000100 MEDICAL PARKWAY 07/31/2021 09/01/2016 09/01/2016 09/01/2016 Current

LAKEWAY, TX 78738

BAYLOR SCOTT & WHITE MEDICAL

CENTER - MARBLE FALLS

100310 8302018000810 W HIGHWAY 71 07/31/2021 07/02/2015 07/02/2015 07/02/2015 Current

MARBLE FALLS, TX 78654

BAYLOR SCOTT & WHITE MEDICAL

CENTER - MCKINNEY

100153 46976422005252 W UNIVERSITY DR 06/30/2022 06/06/2012 06/06/2012 05/24/2021 Current

MCKINNEY, TX 75071

BAYLOR SCOTT & WHITE MEDICAL

CENTER - PFLUGERVILLE

100452 51265461002600 E PFLUGERVILLE PKWY STE 100 11/30/2022 11/13/2018 11/13/2018 09/14/2020 Current

PFLUGERVILLE, TX 78660

BAYLOR SCOTT & WHITE MEDICAL

CENTER - PLANO

008140 46981431764700 ALLIANCE BOULEVARD 11/30/2021 11/16/2004 11/16/2004 07/20/2015 Current

PLANO, TX 75093

BAYLOR SCOTT & WHITE MEDICAL

CENTER - ROUND ROCK

008526 5125090100300 UNIVERSITY BLVD 07/31/2021 07/12/2007 07/12/2007 07/19/2019 Current

ROUND ROCK, TX 78665

BAYLOR SCOTT & WHITE MEDICAL

CENTER - SUNNYVALE

100033 9728923000231 SOUTH COLLINS ROAD 09/30/2021 09/11/2009 09/11/2009 09/27/2019 Current

SUNNYVALE, TX 75182

BAYLOR SCOTT & WHITE MEDICAL

CENTER - TAYLOR

100096 7378883100305 MALLARD LN 08/31/2022 09/01/2010 09/01/2010 09/14/2020 Current

TAYLOR, TX 76574

BAYLOR SCOTT & WHITE MEDICAL

CENTER - TEMPLE

000537 25472421112401 S 31ST ST 03/31/2022 01/01/1964 01/01/1964 09/24/2020 Current

TEMPLE, TX 76508

Page 5 of 456/10/2021

Page 6: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BAYLOR SCOTT & WHITE MEDICAL

CENTER - TROPHY CLUB

008051 81783746002850 EAST STATE HWY 114 04/30/2022 04/23/2004 04/23/2004 10/05/2018 Current

TROPHY CLUB, TX 76262

BAYLOR SCOTT & WHITE MEDICAL

CENTER - UPTOWN

100086 21444330402727 EAST LEMMON AVENUE 02/28/2023 02/02/2011 02/02/2011 04/03/2019 Current

DALLAS, TX 75204

BAYLOR SCOTT & WHITE MEDICAL

CENTER - WAXAHACHIE

100275 46984340002400 N IH 35 E 10/31/2022 10/31/2014 10/31/2014 06/01/2021 Current

WAXAHACHIE, TX 75165

BAYLOR SCOTT & WHITE ORTHOPEDIC

AND SPINE HOSPITAL

100044 8175837100707 HIGHLANDER BOULEVARD 01/31/2022 01/22/2010 01/22/2010 06/20/2019 Current

ARLINGTON, TX 76015

BAYLOR SCOTT & WHITE PAVILION -

TEMPLE

000537 25472444061815 S 31ST ST 03/31/2022 02/26/2003 02/26/2003 03/23/2020 Current

TEMPLE, TX 76504

BAYLOR SCOTT & WHITE SURGICAL

HOSPITAL - FORT WORTH

100271 68270356001800 PARK PLACE AVENUE 10/31/2022 10/09/2014 10/09/2014 05/31/2019 Current

FORT WORTH, TX 76110

BAYLOR SCOTT & WHITE SURGICAL

HOSPITAL - LAS COLINAS

007995 9728684000400 WEST INTERSTATE 635 10/31/2022 10/20/2003 10/20/2003 10/16/2020 Current

IRVING, TX 75063

BAYLOR SCOTT & WHITE SURGICAL

HOSPITAL AT SHERMAN

100320 90387009993601 N CALAIS STREET 05/31/2023 06/01/2015 06/01/2015 06/01/2015 Current

SHERMAN, TX 75090

BAYLOR SCOTT & WHITE TEXAS SPINE

& JOINT HOSPITAL

007902 90352533001814 ROSELAND BOULEVARD 12/31/2021 12/11/2002 12/11/2002 09/28/2017 Current

TYLER, TX 75701

BAYLOR SCOTT & WHITE THE HEART

HOSPITAL - DENTON

100208 94022006002801 SOUTH MAYHILL ROAD 05/31/2023 05/31/2013 05/31/2013 04/04/2018 Current

DENTON, TX 76208

BAYLOR SCOTT & WHITE THE HEART

HOSPITAL - MCKINNEY

008440 46981435115268 W UNIVERSITY DRIVE 01/31/2023 07/24/2019 07/24/2019 07/24/2019 Current

MCKINNEY, TX 75071

BAYLOR SCOTT & WHITE THE HEART

HOSPITAL - PLANO

008440 46981435001100 ALLIED DRIVE 01/31/2023 01/18/2007 01/18/2007 04/13/2020 Current

PLANO, TX 75093

BAYLOR ST LUKES MEDICAL CENTER -

MCNAIR CAMPUS

000118 83235410007200 CAMBRIDGE STREET 01/31/2023 04/04/2019 04/04/2019 04/04/2019 Current

HOUSTON, TX 77030

Page 6 of 456/10/2021

Page 7: Profession Roster Report · 100254 1626 w baker rd 2818377600 04/30/2022 04/09/2014 09/24/2020 current baytown, tx 77521 altus houston hospital, celestial hospital, odyssey hospital

License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BAYLOR UNIVERSITY MEDICAL

CENTER

000331 21482001113500 GASTON AVENUE 12/31/2021 01/01/1960 01/01/1960 12/18/2019 Current

DALLAS, TX 75246

BAYSIDE COMMUNITY HOSPITAL000442 4092673143200 HOSPITAL DRIVE 09/30/2021 01/08/1960 01/08/1960 10/01/1998 Current

ANAHUAC, TX 77514

BAYVIEW BEHAVIORAL HOSPITAL, A

CAMPUS OF CORPUS CHRISTI

MEDICAL

000703 36198682006629 WOOLRIDGE ROAD 09/30/2022 10/07/2011 05/03/2012 09/15/2020 Current

CORPUS CHRISTI, TX 78414

BEAUMONT EMERGENCY HOSPITAL100532 40984040044004 COLLEGE STREET 11/30/2022 11/18/2020 11/18/2020 02/01/2021 Current

BEAUMONT, TX 77707

BEHAVIORAL MEDICINE AT

RENAISSANCE

007971 95636272935510 RAPHAEL DRIVE 07/31/2022 12/06/2007 12/06/2007 07/13/2020 Current

EDINBURG, TX 78539

BEHAVIORAL HEALTH SERVICES AT

NWTHS

000318 80635411107201 EVANS 05/31/2023 07/11/1993 07/11/1993 12/09/2008 Current

AMARILLO, TX 79106

BELLVILLE MEDICAL CENTER100120 979413740044 NORTH CUMMINGS STREET 12/31/2022 12/30/2010 12/30/2010 07/11/2019 Current

BELLVILLE, TX 77418

BIG BEND REGIONAL MEDICAL

CENTER

007119 43283734472600 HIGHWAY 118 NORTH 08/31/2022 09/01/1999 09/01/1999 08/19/2020 Current

ALPINE, TX 79830

BROWNFIELD REGIONAL MEDICAL

CENTER

000078 8066373551705 EAST FELT STREET 10/31/2021 10/12/1971 10/12/1971 09/19/2019 Current

BROWNFIELD, TX 79316

BRUSHY CREEK FAMILY HOSPITAL LLC100495 5127661400230 DEER RIDGE DR 11/30/2021 11/15/2019 11/15/2019 11/15/2019 Current

ROUND ROCK, TX 78681

CAPROCK HOSPITAL100420 97931423233134 BRIARCREST DR 02/28/2022 02/27/2018 02/27/2018 02/27/2018 Current

BRYAN, TX 77802

CARROLLTON REGIONAL MEDICAL

CENTER

100513 97239422584343 NORTH JOSEY LANE 02/28/2022 02/29/2020 02/29/2020 04/01/2020 Current

CARROLLTON, TX 75010

CARRUS REHABILITATION HOSPITAL100059 90387026001810 WEST HIGHWAY 82 STE 100 06/30/2022 06/16/2010 06/16/2010 06/16/2010 Current

SHERMAN, TX 75902

CARRUS SPECIALTY HOSPITAL100049 90387026001810 US HWY 82 WEST STE 200 02/28/2022 02/18/2010 02/18/2010 10/03/2018 Current

SHERMAN, TX 75092

CECIL R BOMAR REHABILITATION

CENTER

000478 9365647422707 WOOD STREET 12/31/2021 12/28/1999 12/28/1999 01/02/2020 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

NACOGDOCHES, TX 75961

CEDAR PARK REGIONAL MEDICAL

CENTER

008583 51252870001401 MEDICAL PARKWAY 11/30/2021 11/07/2007 11/07/2007 03/08/2021 Current

CEDAR PARK, TX 78613

CENTRAL TEXAS REHABILITATION

HOSPITAL

100147 5124072111700 W 45TH STREET 04/30/2022 04/26/2012 04/26/2012 04/27/2012 Current

AUSTIN, TX 78751

CHI ST JOSEPH HEALTH - COLLEGE

STATION HOSPITAL

100486 97976451001604 ROCK PRAIRIE ROAD 07/31/2021 07/31/2019 07/31/2019 06/17/2020 Current

COLLEGE STATION, TX 77845

CHI ST JOSEPH HEALTH BURLESON

HOSPITAL

000679 97956732451101 WOODSON DRIVE 10/31/2022 01/01/1960 01/01/1960 09/30/2014 Current

CALDWELL, TX 77836

CHI ST JOSEPH HEALTH GRIMES

HOSPITAL

007288 9368256585210 SOUTH JUDSON 03/31/2023 04/01/2001 04/01/2001 02/10/2021 Current

NAVASOTA, TX 77868

CHI ST JOSEPH HEALTH MADISON

HOSPITAL

000041 9363482631100 WEST CROSS STREET 09/30/2022 01/01/1960 01/01/1960 02/21/2017 Current

MADISONVILLE, TX 77864

CHI ST JOSEPH HEALTH REHAB HOSP,

AFFILIATE OF ENCOMPASS HEALTH

100362 97921343001600 JOSEPH DRIVE SUITE 2000 07/31/2022 07/22/2016 07/22/2016 05/27/2021 Current

BRYAN, TX 77802

CHI ST LUKES HEALTH - BRAZOSPORT000436 9792974411100 MEDICAL DRIVE 02/28/2023 01/01/1960 01/01/1960 02/15/2017 Current

LAKE JACKSON, TX 77566

CHI ST LUKES HEALTH - MEMORIAL

LIVINGSTON

000466 93632987001717 HIGHWAY 59 BYPASS 06/30/2021 01/04/1960 01/04/1960 07/01/1998 Current

LIVINGSTON, TX 77351

CHI ST LUKES HEALTH -

SPRINGWOODS VILLAGE

007931 34630550002255 E MOSSY OAKS ROAD 03/31/2022 01/04/2016 01/04/2016 01/04/2016 Current

SPRING, TX 77389

CHI ST LUKES HEALTH BAYLOR

COLLEGE OF MEDICINE MEDICAL

CENTER

000118 71378585376720 BERTNER 01/31/2023 01/01/1960 01/01/1960 04/29/2021 Current

HOUSTON, TX 77030

CHI ST LUKES HEALTH MEMORIAL

LUFKIN

000129 93663481111201 WEST FRANK STREET 12/31/2022 01/01/1960 01/01/1960 12/16/2020 Current

LUFKIN, TX 75904

CHI ST LUKES HEALTH MEMORIAL

SAN AUGUSTINE

000072 9362753446511 HOSPITAL STREET 06/30/2023 01/01/1960 01/01/1960 01/30/2015 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

SAN AUGUSTINE, TX 75972

CHILDRENS HOSPITAL OF SAN

ANTONIO

100166 2107042317333 NORTH SANTA ROSA STREET 09/30/2022 09/16/2012 09/16/2012 12/05/2014 Current

SAN ANTONIO, TX 78207

CHILDRENS MEDICAL CENTER OF

DALLAS

000143 21445621431935 MEDICAL DISTRICT DRIVE 08/31/2022 08/05/1967 08/05/1967 04/07/2015 Current

DALLAS, TX 75235

CHILDRENS MEDICAL CENTER PLANO100291 46930370007601 PRESTON ROAD 04/30/2023 04/07/2015 04/07/2015 04/07/2015 Current

PLANO, TX 75024

CHILDRESS REGIONAL MEDICAL

CENTER

000026 9409376371901 US HIGHWAY 83 N 02/28/2023 03/10/1970 03/10/1970 07/02/2020 Current

CHILDRESS, TX 79201

CHRISTUS DUBUIS HOSPITAL OF

BEAUMONT

100414 40989981562830 CALDER STREET 4TH FLOOR 08/31/2021 09/01/2017 09/01/2017 02/14/2018 Current

BEAUMONT, TX 77702

CHRISTUS GOOD SHEPHERD MEDICAL

CENTER - LONGVIEW

000020 9033151811700 E MARSHALL AVENUE 03/31/2023 09/01/2017 09/01/2017 07/10/2018 Current

LONGVIEW, TX 75601

CHRISTUS GOOD SHEPHERD MEDICAL

CENTER - MARSHALL

000020 9039276000811 SOUTH WASHINGTON 03/31/2023 01/01/1960 01/01/1960 09/12/2017 Current

MARSHALL, TX 75670

CHRISTUS MOTHER FRANCES

HOSPITAL - JACKSONVILLE

007254 90354145002026 SOUTH JACKSON 12/31/2021 12/21/2000 12/21/2000 05/26/2016 Current

JACKSONVILLE, TX 75766

CHRISTUS MOTHER FRANCES

HOSPITAL - SOUTH TYLER

000286 90360665008389 S BROADWAY AVENUE 02/28/2023 02/02/2017 02/02/2017 02/02/2017 Current

TYLER, TX 75703

CHRISTUS MOTHER FRANCES

HOSPITAL - SULPHUR SPRINGS

100359 9034394052115 AIRPORT ROAD 07/31/2022 07/12/2016 07/12/2016 07/12/2016 Current

SULPHUR SPRINGS, TX 75482

CHRISTUS MOTHER FRANCES

HOSPITAL - TYLER

000286 9035315400800 EAST DAWSON 02/28/2023 01/01/1960 01/01/1960 03/09/2021 Current

TYLER, TX 75701

CHRISTUS MOTHER FRANCES

HOSPITAL - WINNSBORO

000446 9033425227719 WEST COKE ROAD 12/31/2021 01/31/1961 01/31/1961 05/26/2016 Current

WINNSBORO, TX 75494

CHRISTUS SANTA ROSA HOSPITAL -

ALAMO HEIGHTS

000339 2102948000403 TREELINE PARK 02/28/2022 11/01/2017 11/01/2017 11/01/2017 Current

SAN ANTONIO, TX 78209

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

CHRISTUS SANTA ROSA HOSPITAL -

MEDICAL CENTER

000339 21070560212827 BABCOCK ROAD 02/28/2022 11/01/2002 11/01/2002 10/01/2020 Current

SAN ANTONIO, TX 78229

CHRISTUS SANTA ROSA HOSPITAL -

NEW BRAUNFELS

100165 8306062170600 NORTH UNION AVENUE 09/30/2022 09/16/2012 09/16/2012 09/16/2012 Current

NEW BRAUNFELS, TX 78130

CHRISTUS SANTA ROSA HOSPITAL -

SAN MARCOS

100514 51235389791301 WONDER WORLD DRIVE 03/31/2022 04/01/2020 04/01/2020 04/02/2020 Current

SAN MARCOS, TX 78666

CHRISTUS SANTA ROSA HOSPITAL -

WESTOVER HILLS

000339 210703800011212 STATE HIGHWAY 151 02/28/2022 07/02/2009 07/02/2009 08/07/2018 Current

SAN ANTONIO, TX 78251

CHRISTUS SOUTHEAST TEXAS -

JASPER MEMORIAL

000038 40938454611275 MARVIN HANCOCK DRIVE 01/31/2023 11/29/1968 11/29/1968 01/04/2021 Current

JASPER, TX 75951

CHRISTUS SOUTHEAST TEXAS - ST

ELIZABETH & ST MARY

000444 40989971062830 CALDER 01/31/2023 05/14/1962 05/14/1962 07/19/2019 Current

BEAUMONT, TX 77702

CHRISTUS SOUTHEAST TEXAS

ORTHOPEDIC SPECIALTY CENTER

000444 40983803463650 LAUREL AVENUE 01/31/2023 12/05/2013 12/05/2013 12/05/2013 Current

BEAUMONT, TX 77707

CHRISTUS SPOHN HOSPITAL ALICE006894 36166180152500 EAST MAIN STREET 06/30/2023 03/15/1999 03/15/1999 06/07/2021 Current

ALICE, TX 78332

CHRISTUS SPOHN HOSPITAL BEEVILLE000429 36135421251500 EAST HOUSTON HIGHWAY 06/30/2022 02/01/1964 02/01/1964 06/18/2020 Current

BEEVILLE, TX 78102

CHRISTUS SPOHN HOSPITAL CORPUS

CHRISTI

000398 36188131482606 HOSPITAL BOULEVARD 09/30/2021 02/22/1960 02/22/1960 09/30/2014 Current

CORPUS CHRISTI, TX 78405

CHRISTUS SPOHN HOSPITAL CORPUS

CHRISTI SHORELINE

000398 3618813148600 ELIZABETH STREET 09/30/2021 06/01/2003 06/01/2003 01/15/2020 Current

CORPUS CHRISTI, TX 78404

CHRISTUS SPOHN HOSPITAL CORPUS

CHRISTI SOUTH

000398 36198551035950 SARATOGA BOULEVARD 09/30/2021 06/01/2003 06/01/2003 02/06/2003 Current

CORPUS CHRISTI, TX 78414

CHRISTUS SPOHN HOSPITAL KLEBERG000216 36159516611311 EAST GENERAL CAVAZOS

BOULEVARD

06/30/2023 01/01/1960 01/01/1960 06/21/2012 Current

KINGSVILLE, TX 78363

CHRISTUS ST MICHAEL HEALTH

SYSTEM

000788 90361422112600 ST MICHAEL DRIVE 01/31/2023 12/01/1994 12/01/1994 06/13/2016 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

TEXARKANA, TX 75503

CHRISTUS ST MARY OUTPATIENT

CENTER MID COUNTY

000444 40972436008801 9TH AVENUE 01/31/2023 04/25/2017 04/25/2017 04/25/2017 Current

PORT ARTHUR, TX 77642

CHRISTUS ST MICHAEL HOSPITAL -

ATLANTA

000788 90379930001007 SOUTH WILLIAM STREET 01/31/2023 01/01/2013 01/03/2013 01/01/2013 Current

ATLANTA, TX 75551

CHRISTUS ST MICHAEL

REHABILITATION HOSPITAL

000713 90361440002400 ST MICHAEL DRIVE 01/31/2022 01/27/1994 01/27/1994 02/01/1999 Current

TEXARKANA, TX 75503

CHRISTUS TRINITY MOTHER FRANCES

REHAB HOSP, PARTNER OF

ENCOMPASS

000692 90351070003131 TROUP HIGHWAY 02/28/2023 02/03/1993 02/03/1993 04/05/2018 Current

TYLER, TX 75701

CITIZENS MEDICAL CENTER000064 36157391812701 HOSPITAL DRIVE 03/31/2023 01/01/1960 01/01/1960 07/26/2019 Current

VICTORIA, TX 77901

CITY HOSPITAL AT WHITE ROCK100422 21432461009440 POPPY DRIVE 02/28/2022 03/01/2018 03/01/2018 04/13/2020 Current

DALLAS, TX 75218

CLAY COUNTY MEMORIAL HOSPITAL000193 9405385621310 WEST SOUTH STREET 10/31/2022 01/01/1960 01/01/1960 11/01/1998 Current

HENRIETTA, TX 76365

CLEARSKY REHABILITATION HOSPITAL

OF FLOWER MOUND

100533 46993328553100 PETERS COLONY ROAD 11/30/2022 11/18/2020 11/18/2020 11/18/2020 Current

FLOWER MOUND, TX 75022

CLEVELAND EMERGENCY HOSPITAL100332 28159254001017 S TRAVIS 08/31/2021 08/21/2015 08/21/2015 09/17/2019 Current

CLEVELAND, TX 77327

COBALT REHABILITATION HOSPITAL

EL PASO

100479 91597586301600 E CLIFF DRIVE 09/30/2021 09/06/2019 09/06/2019 09/06/2019 Current

EL PASO, TX 79902

COBALT REHABILITATION HOUSTON

HEIGHTS

100478 71381491001917 ASHLAND STREET 4TH FLOOR 09/30/2021 09/04/2019 09/04/2019 09/04/2019 Current

HOUSTON, TX 77008

COCHRAN MEMORIAL HOSPITAL000159 8069466776114 W. WILSON 04/30/2022 01/01/1960 01/01/1960 05/01/1998 Current

MORTON, TX 79346

COGDELL MEMORIAL HOSPITAL008691 32557474371700 COGDELL BLVD. 08/31/2022 07/03/2008 07/03/2008 06/25/2015 Current

SNYDER, TX 79549

COLEMAN COUNTY MEDICAL CENTER

COMPANY

100168 3256252135310 SOUTH PECOS STREET 03/31/2022 03/01/2012 03/01/2012 03/01/2012 Current

COLEMAN, TX 76834

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

COLLINGSWORTH GENERAL HOSPITAL008209 80644725211013 15TH STREET 03/31/2022 04/01/2004 04/01/2004 02/01/2011 Current

WELLINGTON, TX 79095

COLUMBUS COMMUNITY HOSPITAL000014 9797322371110 SHULT DRIVE 09/30/2021 10/06/1975 10/06/1975 10/01/1998 Current

COLUMBUS, TX 78934

COMANCHE COUNTY MEDICAL

CENTER

100123 254879490010201 HIGHWAY 16 NORTH 12/31/2021 01/01/2011 12/07/2011 10/21/2014 Current

COMANCHE, TX 76442

CONCHO COUNTY HOSPITAL000202 3258695911614 EAKER STREET 08/31/2021 08/14/1968 08/14/1968 09/11/2019 Current

EDEN, TX 76837

CONNALLY MEMORIAL MEDICAL

CENTER

000433 8303931303499 10TH STREET 08/31/2022 05/20/1960 05/20/1960 08/07/2006 Current

FLORESVILLE, TX 78114

CONTINUECARE HOSPITAL AT

HENDRICK MEDICAL CENTER

100285 32567062511900 PINE STREET 7TH FLOOR 12/31/2022 12/17/2014 12/17/2014 11/08/2016 Current

ABILENE, TX 79601

CONTINUECARE HOSPITAL AT

MEDICAL CENTER ODESSA

100305 4326404380500 W 4TH STREET 4TH FLOOR 05/31/2023 05/29/2015 05/29/2015 04/19/2017 Current

ODESSA, TX 79761

COOK CHILDRENS MEDICAL CENTER000332 6828854340801 SEVENTH AVENUE 09/30/2021 01/01/1960 01/01/1960 08/05/2019 Current

FORT WORTH, TX 76104

COON MEMORIAL HOSPITAL AND

HOME

000262 80624492671411 DENVER AVENUE 08/31/2021 01/01/1960 01/01/1960 09/01/1998 Current

DALHART, TX 79022

CORNERSTONE REGIONAL HOSPITAL000830 95661844442302 CORNERSTONE BOULEVARD 10/31/2021 10/08/1998 10/08/1998 10/31/2001 Current

EDINBURG, TX 78539

CORNERSTONE SPECIALTY HOSPITALS

AUSTIN

100293 51270619004207 BURNET ROAD 01/31/2023 02/01/2015 02/01/2015 11/07/2018 Current

AUSTIN, TX 78756

CORNERSTONE SPECIALTY HOSPITALS

CLEAR LAKE

100314 2813323322709 MEDICAL CENTER BLVD 05/31/2023 06/01/2015 06/01/2015 05/01/2020 Current

WEBSTER, TX 77598

CORNERSTONE SPECIALTY HOSPITALS

CONROE

100317 93652318001500 GRAND LAKE DRIVE 05/31/2023 06/01/2015 06/01/2015 11/07/2018 Current

CONROE, TX 77304

CORNERSTONE SPECIALTY HOSPITALS

HOUSTON MEDICAL CENTER

100412 71328510001300 BINZ 07/31/2021 08/01/2017 08/01/2017 11/26/2019 Current

HOUSTON, TX 77004

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

CORNERSTONE SPECIALTY HOSPITALS

ROUND ROCK

100293 51267111004681 COLLEGE PARK DRIVE 01/31/2023 02/01/2015 02/01/2015 02/01/2015 Current

ROUND ROCK, TX 78665

CORPUS CHRISTI REHABILITATION

HOSPITAL

100217 36190637005726 ESPLANADE DRIVE 07/31/2021 07/19/2013 07/19/2013 07/29/2020 Current

CORPUS CHRISTI, TX 78414

CORYELL MEMORIAL HOSPITAL000346 25486582511507 WEST MAIN STREET 12/31/2021 01/01/1960 01/01/1960 01/01/1999 Current

GATESVILLE, TX 76528

COVENANT CHILDRENS HOSPITAL008638 80672579604015 22ND PLACE 03/31/2022 03/19/2008 03/19/2008 03/30/2020 Current

LUBBOCK, TX 79410

COVENANT HOSPITAL LEVELLAND000307 80689449631900 COLLEGE AVENUE 10/31/2022 11/08/1971 11/08/1971 09/24/2014 Current

LEVELLAND, TX 79336

COVENANT HOSPITAL PLAINVIEW000146 80629642652601 DIMMIT ROAD 05/31/2023 07/07/1970 07/07/1970 06/01/1998 Current

PLAINVIEW, TX 79072

COVENANT MEDICAL CENTER100454 80672500003615 19TH STREET 12/31/2022 01/01/2019 01/01/2019 01/01/2019 Current

LUBBOCK, TX 79410

COVENANT SPECIALTY HOSPITAL008462 80672592003815 20TH STREET 02/28/2023 02/16/2007 02/16/2007 02/09/2011 Current

LUBBOCK, TX 79410

CRANE MEMORIAL HOSPITAL008726 43255835551310 SOUTH ALFORD STREET 09/30/2022 09/16/2008 09/16/2008 09/16/2008 Current

CRANE, TX 79731

CRESCENT MEDICAL CENTER

LANCASTER

100202 46929753212600 WEST PLEASANT RUN ROAD 06/30/2021 06/11/2013 06/11/2013 06/21/2019 Current

LANCASTER, TX 75146

CROCKETT MEDICAL CENTER100417 93654638911100 E LOOP 304 01/31/2022 01/16/2018 01/16/2018 01/31/2018 Current

CROCKETT, TX 75835

CROSBYTON CLINIC HOSPITAL000176 8066752382710 WEST MAIN STREET 03/31/2023 01/01/1960 01/01/1960 04/24/2019 Current

CROSBYTON, TX 79322

CUERO REGIONAL HOSPITAL000074 36127561912550 NORTH ESPLANADE 06/30/2023 06/24/1970 06/24/1970 01/25/2017 Current

CUERO, TX 77954

CULBERSON HOSPITAL008172 4322832760EISENHOWER-FM 2185 07/31/2022 08/01/2004 08/01/2004 08/01/2004 Current

VAN HORN, TX 79855

DALLAS MEDICAL CENTER100214 97224710007 MEDICAL PARKWAY 02/28/2022 03/01/2010 03/01/2010 01/29/2020 Current

DALLAS, TX 75234

DALLAS REGIONAL MEDICAL CENTER100292 21432077871011 NORTH GALLOWAY AVE 03/31/2023 03/01/2015 03/01/2015 03/01/2015 Current

MESQUITE, TX 75149

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DEL SOL MEDICAL CENTER A CAMPUS

OF LPDS HEALTHCARE

000180 915595900010301 GATEWAY BOULEVARD WEST 06/30/2021 07/20/2009 07/20/2009 07/03/2019 Current

EL PASO, TX 79925

DELL CHILDRENS MEDICAL CENTER008520 51232401014900 MUELLER BLVD 06/30/2023 06/13/2007 06/13/2007 06/03/2021 Current

AUSTIN, TX 78723

DELL SETON MEDICAL CENTER AT THE

UNIVERSITY OF TEXAS

000335 51232470001500 RED RIVER STREET 09/30/2022 05/10/2017 05/10/2017 07/19/2019 Current

AUSTIN, TX 78701

DETAR HEALTHCARE SYSTEM000453 3615736100101 MEDICAL DRIVE 09/30/2022 11/01/2000 11/01/2000 10/01/1998 Current

VICTORIA, TX 77904

DETAR HEALTHCARE SYSTEM000453 3615757441506 EAST SAN ANTONIO STREET 09/30/2022 01/11/1960 01/11/1960 01/08/2021 Current

VICTORIA, TX 77901

DIMMIT REGIONAL HOSPITAL100175 8308762424704 HOSPITAL DRIVE 03/31/2022 03/01/2010 03/01/2010 04/03/2017 Current

CARRIZO SPRINGS, TX 78834

DOCTORS HOSPITAL AT RENAISSANCE007971 95636273605501 SOUTH MCCOLL 07/31/2022 07/25/2003 07/25/2003 07/13/2020 Current

EDINBURG, TX 78539

DOCTORS HOSPITAL OF LAREDO000301 956523200010700 MCPHERSON ROAD 05/31/2022 05/08/1974 05/08/1974 06/01/1999 Current

LAREDO, TX 78045

DRISCOLL CHILDRENS HOSPITAL000488 36169450213533 SOUTH ALAMEDA 03/31/2023 01/12/1960 01/12/1960 09/02/2020 Current

CORPUS CHRISTI, TX 78411

EASTLAND MEMORIAL HOSPITAL000222 2546292601304 SOUTH DAUGHERTY 12/31/2022 01/01/1960 01/01/1960 12/21/2010 Current

EASTLAND, TX 76448

EL CAMPO MEMORIAL HOSPITAL100127 9795436251303 SANDY CORNER ROAD 10/31/2021 10/31/2011 10/31/2011 10/31/2011 Current

EL CAMPO, TX 77437

EL PASO LTAC HOSPITAL008413 91554658221221 NORTH COTTON, 3RD FLOOR 10/31/2022 10/12/2006 10/12/2006 10/12/2006 Current

EL PASO, TX 79902

EL PASO CHILDRENS HOSPITAL100133 91524286004845 ALAMEDA AVE 02/28/2022 02/08/2012 02/08/2012 02/09/2018 Current

EL PASO, TX 79905

ELECTRA MEMORIAL HOSPITAL000490 94049539811207 SOUTH BAILEY STREET 06/30/2023 06/23/1976 06/23/1976 06/20/2012 Current

ELECTRA, TX 76360

ELITE CARE EMERGENCY CENTER100538 28133775002530 GULF FREEWAY S 03/31/2023 03/29/2021 03/29/2021 03/29/2021 Current

LEAGUE CITY, TX 77573

EMINENT MEDICAL CENTER100370 46991088001351 W PRESIDENT BUSH HWY 10/31/2022 10/07/2016 10/07/2016 10/07/2016 Current

RICHARDSON, TX 75080

Page 14 of 456/10/2021

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF ABILENE

100036 32569116006401 DIRECTORS PARKWAY 09/30/2021 09/28/2009 09/28/2009 04/03/2018 Current

ABILENE, TX 79606

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF ARLINGTON

000660 81746840003200 MATLOCK ROAD 12/31/2021 05/01/1990 05/01/1990 04/03/2018 Current

ARLINGTON, TX 76015

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF AUSTIN

100143 5127304800330 WEST BEN WHITE BLVD 04/30/2022 04/18/2012 04/18/2012 04/03/2018 Current

AUSTIN, TX 78704

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF CITY VIEW

000662 81737047006701 OAKMONT BOULEVARD 07/31/2021 07/09/1990 07/09/1990 02/01/2021 Current

FORT WORTH, TX 76132

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF CYPRESS

100112 832280250013031 WORTHAM CENTER DRIVE 10/31/2021 10/21/2011 10/21/2011 04/03/2018 Current

HOUSTON, TX 77065

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF DALLAS

100068 21470682007930 NORTHAVEN ROAD 08/31/2022 08/26/2010 08/26/2010 12/11/2020 Current

DALLAS, TX 75230

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF HUMBLE

100245 281446614819002 MCKAY DRIVE 12/31/2021 01/01/2014 01/01/2014 04/03/2018 Current

HUMBLE, TX 77338

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF KATY

100472 281505350023331 GRAND RESERVE DRIVE 08/31/2021 08/28/2019 08/28/2019 08/28/2019 Current

KATY, TX 77494

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF MIDLAND ODESSA

000693 43252016001800 HERITAGE BOULEVARD 12/31/2021 01/27/1993 01/27/1993 04/05/2018 Current

MIDLAND, TX 79707

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF PEARLAND

100402 34690730002121 BUSINESS CENTER DRIVE 10/31/2021 10/12/2017 10/12/2017 05/12/2020 Current

PEARLAND, TX 77584

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF PLANO

000670 97261290002800 WEST 15TH STREET 06/30/2023 03/25/1991 03/25/1991 04/03/2018 Current

PLANO, TX 75075

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF RICHARDSON

008613 97239857003351 WATERVIEW PARKWAY 01/31/2022 01/08/2008 01/08/2008 04/03/2018 Current

RICHARDSON, TX 75080

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF ROUND ROCK

008661 51224444001400 HESTERS CROSSING 06/30/2022 06/12/2008 06/12/2008 06/18/2020 Current

ROUND ROCK, TX 78681

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF SAN ANTONIO

000636 21069107379119 CINNAMON HILL 12/31/2021 05/02/1988 05/02/1988 04/03/2018 Current

SAN ANTONIO, TX 78240

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF SUGAR LAND

100071 28127675741325 HIGHWAY 6 09/30/2022 09/20/2010 10/04/2010 04/03/2018 Current

SUGAR LAND, TX 77478

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF TEXARKANA

000684 9037355000515 WEST 12TH STREET 12/31/2021 04/13/1992 04/13/1992 04/03/2018 Current

TEXARKANA, TX 75501

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF THE MID-CITIES

100070 81768420002304 STATE HIGHWAY 121 09/30/2022 09/30/2010 09/30/2010 04/03/2018 Current

BEDFORD, TX 76021

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF THE WOODLANDS

000695 281364200018550 IH 45 SOUTH 12/31/2021 06/01/1993 06/01/1993 04/03/2018 Current

CONROE, TX 77384

ENCOMPASS HEALTH REHABILITATION

HOSPITAL OF WICHITA FALLS

000685 94072057003901 ARMORY ROAD 07/31/2022 07/06/1992 07/06/1992 04/03/2018 Current

WICHITA FALLS, TX 76302

ENCOMPASS HEALTH REHABILITATION

HOSPITAL THE VINTAGE

100140 281205510020180 CHASEWOOD PARK DRIVE 04/30/2022 04/13/2012 04/13/2012 04/03/2018 Current

HOUSTON, TX 77070

ENCOMPASS HEALTH REHABILITATION

HOSPITAL VISION PARK

008737 9364441700117 VISION PARK BLVD 12/31/2022 12/19/2008 12/19/2008 04/03/2018 Current

SHENANDOAH, TX 77384

ENNIS REGIONAL MEDICAL CENTER008531 97287509002201 WEST LAMPASAS STREET 07/31/2021 07/20/2007 07/20/2007 10/24/2007 Current

ENNIS, TX 75119

EVEREST REHABILITATION HOSPITAL

LONGVIEW

100470 4302404600701 E LOOP 281 08/31/2021 08/01/2019 08/01/2019 08/01/2019 Current

LONGVIEW, TX 75605

EVEREST REHABILITATION HOSPITAL

TEMPLE

100475 254410055523621 SE H K DODGEN LOOP 08/31/2021 08/29/2019 08/29/2019 08/29/2019 Current

TEMPLE, TX 76504

FAITH COMMUNITY HOSPITAL100322 9405676633215 CHISHOLM TRAIL 09/30/2021 09/15/2015 09/15/2015 09/15/2015 Current

JACKSBORO, TX 76458

FALLS COMMUNITY HOSPITAL AND

CLINIC

000517 2548033561322 COLEMAN STREET 09/30/2022 01/15/1963 01/15/1963 12/13/2012 Current

MARLIN, TX 76661

FIRST BAPTIST MEDICAL CENTER100342 46932937008111 MEADOW RD 03/31/2022 03/02/2016 03/02/2016 03/02/2016 Current

DALLAS, TX 75231

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

FIRST SURGICAL HOSPITAL100491 71327511114801 BISSONNET STREET 09/30/2021 09/30/2019 09/30/2019 09/30/2019 Current

BELLAIRE, TX 77401

FISHER COUNTY HOSPITAL DISTRICT000355 3257352256774 STATE HWY 70 NORTH 10/31/2022 07/12/1976 07/12/1976 11/01/1998 Current

ROTAN, TX 79546

FORT DUNCAN REGIONAL MEDICAL

CENTER

000547 83077353213333 NORTH FOSTER MALDONADO 09/30/2022 09/07/1969 09/07/1969 09/15/2000 Current

EAGLE PASS, TX 78852

FOUNDATION SURGICAL HOSPITAL OF

SAN ANTONIO

008521 21047854009522 HUEBNER ROAD 06/30/2021 06/28/2007 06/28/2007 06/28/2007 Current

SAN ANTONIO, TX 78240

FREESTONE MEDICAL CENTER100380 9033892121125 NEWMAN STREET 12/31/2022 01/01/2017 01/01/2017 01/01/2017 Current

FAIRFIELD, TX 75840

FRIO REGIONAL HOSPITAL000441 8303343617200 S IH-35 12/31/2021 12/07/1962 12/07/1962 03/17/2020 Current

PEARSALL, TX 78061

GLEN ROSE MEDICAL CENTER100213 25489722151021 HOLDEN STREET 07/31/2021 08/01/2013 08/01/2013 08/01/2013 Current

GLEN ROSE, TX 76043

GOLDEN PLAINS COMMUNITY

HOSPITAL

100111 8064675700100 MEDICAL DRIVE 10/31/2021 10/18/2011 10/18/2011 10/18/2011 Current

BORGER, TX 79007

GOODALL-WITCHER HOSPITAL100467 2546758322101 POSEY AVE 06/30/2023 07/01/2019 07/01/2019 07/01/2019 Current

CLIFTON, TX 76634

GRACE SURGICAL HOSPITAL008730 80672540007509 MARSHA SHARP FWY 09/30/2022 11/17/2020 11/17/2020 02/02/2021 Current

LUBBOCK, TX 79407

GRAHAM HOSPITAL DISTRICT100252 94054934001301 MONTGOMERY ROAD 01/31/2022 02/01/2014 02/01/2014 07/27/2020 Current

GRAHAM, TX 76450

GUADALUPE REGIONAL MEDICAL

CENTER

000155 83037924111215 EAST COURT STREET 08/31/2022 08/30/1965 08/30/1965 05/17/2018 Current

SEGUIN, TX 78155

HAMILTON GENERAL HOSPITAL000640 2543861950400 NORTH BROWN AVENUE 05/31/2023 08/30/1988 08/30/1988 03/28/2018 Current

HAMILTON, TX 76531

HAMILTON HOSPITAL000294 9405645521901 WEST HAMILTON STREET 03/31/2023 01/01/1960 01/01/1960 02/07/2011 Current

OLNEY, TX 76374

HANSFORD COUNTY HOSPITAL000395 8066592535707 SOUTH ROLAND 09/30/2022 01/01/1960 01/01/1960 09/17/2020 Current

SPEARMAN, TX 79081

HARDEMAN COUNTY MEMORIAL

HOSPITAL

000102 9406632795402 MERCER STREET 01/31/2023 03/28/1967 03/28/1967 12/07/2020 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

QUANAH, TX 79252

HARLINGEN MEDICAL CENTER007880 95636510005501 SOUTH EXPRESSWAY 77 09/30/2021 09/25/2002 09/25/2002 08/20/2019 Current

HARLINGEN, TX 78550

HARRIS HEALTH SYSTEM BEN TAUB

HOSPITAL

000459 71356662971504 TAUB LOOP 05/31/2022 05/15/1963 05/15/1963 05/28/2020 Current

HOUSTON, TX 77030

HARRIS HEALTH SYSTEM LYNDON B

JOHNSON HOSPITAL

000459 71356662975656 KELLEY STREET 05/31/2022 11/29/2007 11/29/2007 05/28/2020 Current

HOUSTON, TX 77026

HASKELL MEMORIAL HOSPITAL000572 94086426211 NORTH AVENUE N 02/28/2023 02/15/1960 02/15/1960 01/10/2011 Current

HASKELL, TX 79521

HCA HOUSTON HEALTHCARE CLEAR

LAKE

000212 2813322511500 MEDICAL CENTER BOULEVARD 12/31/2022 01/16/1972 01/16/1972 02/05/2019 Current

WEBSTER, TX 77598

HCA HOUSTON HEALTHCARE CONROE000508 9365391111504 MEDICAL CENTER BOULEVARD 12/31/2021 01/01/1960 01/01/1960 02/05/2019 Current

CONROE, TX 77304

HCA HOUSTON HEALTHCARE

KINGWOOD

000675 281348800122999 US HIGHWAY 59 10/31/2022 05/15/1991 05/15/1991 02/15/2019 Current

KINGWOOD, TX 77339

HCA HOUSTON HEALTHCARE

MAINLAND

000212 40993850006801 EMMETT F LOWERY

EXPRESSWAY

12/31/2022 04/01/2011 04/01/2011 04/01/2011 Current

TEXAS CITY, TX 77591

HCA HOUSTON HEALTHCARE

MEDICAL CENTER

100410 71352750001313 HERMANN DRIVE 07/31/2021 08/01/2017 08/01/2017 02/05/2019 Current

HOUSTON, TX 77004

HCA HOUSTON HEALTHCARE NORTH

CYPRESS

000675 832912350021214 NORTHWEST FREEWAY 10/31/2022 08/31/2018 08/31/2018 08/31/2018 Current

CYPRESS, TX 77429

HCA HOUSTON HEALTHCARE

NORTHWEST

008655 2814401000710 CYPRESS CREEK PARKWAY 05/31/2022 06/02/2008 06/02/2008 02/14/2019 Current

HOUSTON, TX 77090

HCA HOUSTON HEALTHCARE

PEARLAND

100283 713770710011100 SHADOW CREEK PARKWAY 12/31/2022 12/18/2014 12/18/2014 02/05/2019 Current

PEARLAND, TX 77584

HCA HOUSTON HEALTHCARE

SOUTHEAST

000349 71335920004000 SPENCER HIGHWAY 12/31/2021 11/15/1961 11/15/1961 11/27/2019 Current

PASADENA, TX 77504

HCA HOUSTON HEALTHCARE

TOMBALL

100409 2814017500605 HOLDERRIETH BOULEVARD 06/30/2023 07/01/2017 07/01/2017 02/05/2019 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

TOMBALL, TX 77375

HCA HOUSTON HEALTHCARE WEST000337 281558344412141 RICHMOND AVENUE 12/31/2021 05/24/1974 05/24/1974 02/05/2019 Current

HOUSTON, TX 77082

HEALTHBRIDGE CHILDRENS

HOSPITAL-HOUSTON LTD

007125 28129377742929 WOODLAND PARK DRIVE 07/31/2022 10/01/1999 10/01/1999 08/01/2003 Current

HOUSTON, TX 77082

HEART HOSPITAL OF AUSTIN, A

CAMPUS OF ST DAVIDS MEDICAL

CENTER

000035 51240770003801 NORTH LAMAR 04/30/2022 12/07/2010 12/07/2010 12/07/2010 Current

AUSTIN, TX 78756

HEART OF TEXAS HEALTHCARE

SYSTEM

100207 32559729012008 NINE ROAD 03/31/2023 04/01/2011 04/01/2011 04/01/2011 Current

BRADY, TX 76825

HEMPHILL COUNTY HOSPITAL000457 80632364221020 SOUTH 4TH STREET 06/30/2022 01/07/1960 01/07/1960 07/01/1998 Current

CANADIAN, TX 79014

HENDRICK MEDICAL CENTER000500 32567020001900 PINE 01/31/2023 01/19/1960 01/19/1960 11/03/2020 Current

ABILENE, TX 79601

HENDRICK MEDICAL CENTER

BROWNWOOD

100528 32564685411501 BURNETT RD 10/31/2022 10/27/2020 10/27/2020 11/03/2020 Current

BROWNWOOD, TX 76801

HENDRICK MEDICAL CENTER SOUTH000500 32542810106250 US HIGHWAY 83 01/31/2023 10/27/2020 10/27/2020 11/03/2020 Current

ABILENE, TX 79606

HEREFORD REGIONAL MEDICAL

CENTER

100121 8063642141540 WEST 15TH STREET 12/31/2021 12/05/2011 12/05/2011 12/05/2011 Current

HEREFORD, TX 79045

HIGHLANDS REHABILITATION

HOSPITAL

100318 91529872221395 GEORGE DIETER DRIVE 07/31/2021 08/01/2015 08/01/2015 08/01/2015 Current

EL PASO, TX 79936

HILL COUNTRY MEMORIAL HOSPITAL000219 83099743531020 STATE HIGHWAY 16 SOUTH 01/31/2022 01/15/1971 01/15/1971 01/09/2020 Current

FREDERICKSBURG, TX 78624

HILL REGIONAL HOSPITAL000383 2545808500101 CIRCLE DRIVE 07/31/2022 12/20/1961 12/20/1961 05/20/2019 Current

HILLSBORO, TX 76645

HORIZON MEDICAL CENTER OF

DENTON

100363 94032023002813 S MAYHILL RD 07/31/2022 07/29/2016 07/29/2016 05/01/2019 Current

DENTON, TX 76208

HOUSTON METHODIST BAYTOWN

HOSPITAL

000405 28142086004401 GARTH ROAD 01/31/2022 01/06/1960 01/06/1960 10/02/2019 Current

BAYTOWN, TX 77521

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HOUSTON METHODIST CLEAR LAKE

HOSPITAL

100241 281333886518300 HOUSTON METHODIST DR 01/31/2022 02/01/2014 02/01/2014 08/30/2019 Current

HOUSTON, TX 77058

HOUSTON METHODIST CONTINUING

CARE HOSPITAL

100240 8325227550701 S FRY ROAD 01/31/2022 02/01/2014 02/01/2014 01/22/2020 Current

KATY, TX 77450

HOUSTON METHODIST HOSPITAL000124 71379033116565 FANNIN 01/31/2023 01/01/1960 01/01/1960 04/26/2021 Current

HOUSTON, TX 77030

HOUSTON METHODIST SUGAR LAND

HOSPITAL

000823 281274700016655 SOUTHWEST FREEWAY 02/28/2022 02/17/1998 02/17/1998 08/10/2020 Current

SUGAR LAND, TX 77479

HOUSTON METHODIST THE

WOODLANDS HOSPITAL

100386 936270200017201 I-45 SOUTH 04/30/2023 04/17/2017 04/17/2017 10/02/2019 Current

THE WOODLANDS, TX 77385

HOUSTON METHODIST WEST

HOSPITAL

100080 832522100018500 KATY FREEWAY 12/31/2022 12/10/2010 12/10/2010 04/18/2018 Current

HOUSTON, TX 77094

HOUSTON METHODIST

WILLOWBROOK HOSPITAL

007247 281737100018220 STATE HIGHWAY 249 12/31/2021 12/06/2000 12/06/2000 03/09/2020 Current

HOUSTON, TX 77070

HOUSTON PHYSICIANS HOSPITAL008220 2815575621333 NORTH TEXAS AVENUE 05/31/2023 05/12/2005 05/12/2005 06/29/2020 Current

WEBSTER, TX 77598

HUNT REGIONAL MEDICAL CENTER

GREENVILLE

000085 90340850004215 JOE RAMSEY BOULEVARD 09/30/2022 09/17/1971 09/17/1971 09/13/2019 Current

GREENVILLE, TX 75401

HUNTSVILLE MEMORIAL HOSPITAL100511 9362913411110 MEMORIAL HOSPITAL DRIVE 02/28/2022 02/26/2020 02/26/2020 02/28/2020 Current

HUNTSVILLE, TX 77340

IRAAN GENERAL HOSPITAL008651 4326392575600 HIGHWAY 349 NORTH 05/31/2022 05/08/2008 05/08/2008 04/02/2020 Current

IRAAN, TX 79744

JACKSON COUNTY HOSPITAL000017 36178278001013 SOUTH WELLS STREET 08/31/2022 03/29/1973 03/29/1973 09/04/2007 Current

EDNA, TX 77957

JOHN PETER SMITH HOSPITAL000409 81792134311500 S MAIN ST 01/31/2022 01/05/1960 01/05/1960 01/28/2020 Current

FORT WORTH, TX 76104

JPS HEALTH NETWORK - TRINITY

SPRINGS NORTH

000409 81770210881000 ST LOUIS AVENUE 01/31/2022 12/22/2015 12/22/2015 01/28/2020 Current

FORT WORTH, TX 76104

KATE DISHMAN REHABILITATION

HOSPITAL

008619 40989983802830 CALDER ST 6TH FLOOR SOUTH 01/31/2022 01/18/2008 01/18/2008 01/18/2008 Current

Page 20 of 456/10/2021

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

BEAUMONT, TX 77702

KELL WEST REGIONAL HOSPITAL006814 94069258885420 KELL BOULEVARD WEST 01/31/2023 01/15/1999 01/15/1999 12/29/2010 Current

WICHITA FALLS, TX 76310

KIMBLE HOSPITAL100113 3254463321349 REID ROAD 10/31/2021 10/25/2011 10/25/2011 10/25/2011 Current

JUNCTION, TX 76849

KINDRED HOSPITAL - SAN ANTONIO

CENTRAL

100358 2102977195111 DALLAS STREET 4TH FLOOR 06/30/2022 06/28/2016 06/28/2016 06/28/2016 Current

SAN ANTONIO, TX 78205

KINDRED HOSPITAL CLEAR LAKE007204 2813167800350 BLOSSOM STREET 07/31/2021 05/31/2005 05/31/2005 06/14/2019 Current

WEBSTER, TX 77598

KINDRED HOSPITAL DALLAS CENTRAL100016 46923265008050 MEADOW ROAD 06/30/2023 06/30/2009 06/30/2009 07/18/2011 Current

DALLAS, TX 75231

KINDRED HOSPITAL EL PASO007271 91535190441740 CURIE DRIVE 02/28/2022 03/01/2001 03/01/2001 02/10/2020 Current

EL PASO, TX 79902

KINDRED HOSPITAL HOUSTON

MEDICAL CENTER

000676 71379005006441 MAIN STREET 04/30/2023 07/26/1991 07/26/1991 05/26/2020 Current

HOUSTON, TX 77030

KINDRED HOSPITAL HOUSTON NW000706 281517100011297 FALLBROOK DRIVE 12/31/2021 11/24/1993 11/24/1993 01/01/1998 Current

HOUSTON, TX 77065

KINDRED HOSPITAL SUGAR LAND007927 28127560001550 FIRST COLONY BOULEVARD 02/28/2022 03/01/2003 03/01/2003 05/14/2020 Current

SUGAR LAND, TX 77479

KINDRED HOSPITAL-MANSFIELD000657 81747361011802 HIGHWAY 157 NORTH 04/30/2022 01/02/1990 01/02/1990 05/01/1998 Current

MANSFIELD, TX 76063

KINDRED HOSPITAL-SAN ANTONIO000645 21061606163636 MEDICAL DRIVE 04/30/2022 01/05/1989 01/05/1989 07/07/2008 Current

SAN ANTONIO, TX 78229

KINDRED HOSPITAL-TARRANT

COUNTY

000800 81734600947800 OAKMONT BOULEVARD 08/31/2021 09/01/1995 09/01/1995 03/03/2015 Current

FORT WORTH, TX 76132

KINDRED HOSPITAL-TARRANT

COUNTY

000690 81754834001000 NORTH COOPER STREET 11/30/2021 11/30/1992 11/30/1992 03/03/2015 Current

ARLINGTON, TX 76011

KINGWOOD EMERGENCY HOSPITAL100416 832777616523330 HIGHWAY 59 N 01/31/2022 01/26/2018 01/26/2018 10/31/2019 Current

KINGWOOD, TX 77339

KNAPP MEDICAL CENTER000480 95696885671401 EAST EIGHTH STREET 10/31/2021 10/10/1961 10/10/1961 05/16/2019 Current

WESLACO, TX 78596

KNOX COUNTY HOSPITAL000568 9406573535701 SOUTHEAST 5TH STREET 08/31/2021 02/15/1960 02/15/1960 07/29/2019 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

KNOX CITY, TX 79529

KPC PROMISE HOSPITAL OF DALLAS100480 21463700007955 HARRY HINES BOULEVARD 06/30/2023 06/14/2019 06/14/2019 06/14/2019 Current

DALLAS, TX 75235

KPC PROMISE HOSPITAL OF WICHITA

FALLS

100484 94021393701103 GRACE STREET 06/30/2023 06/14/2019 06/14/2019 06/14/2019 Current

WICHITA FALLS, TX 76301

KYLE ER & HOSPITAL100458 71366005575615 KYLE CENTER DR 03/31/2023 03/06/2019 03/06/2019 03/26/2019 Current

KYLE, TX 78640

LAKE GRANBURY MEDICAL CENTER000424 81757322731310 PALUXY ROAD 12/31/2021 03/01/1976 03/01/1976 04/21/2015 Current

GRANBURY, TX 76048

LAKE TRAVIS ER LLC100419 51226027325012 N FM 620 RD 02/28/2022 02/07/2018 02/07/2018 02/07/2018 Current

AUSTIN, TX 78732

LAMB HEALTHCARE CENTER000217 80638564111500 SOUTH SUNSET 07/31/2022 08/01/1979 08/01/1979 12/16/2004 Current

LITTLEFIELD, TX 79339

LAREDO MEDICAL CENTER000207 95679650001700 EAST SAUNDERS STREET 09/30/2022 01/01/1960 01/01/1960 10/01/2003 Current

LAREDO, TX 78041

LAREDO REHABILITATION HOSPITAL100287 95676485552005 A BUSTAMANTE STREET 01/31/2023 01/16/2015 01/16/2015 03/05/2020 Current

LAREDO, TX 78041

LAREDO SPECIALTY HOSPITAL008363 95675353532005 BUSTAMANTE ST 05/31/2022 05/11/2006 05/11/2006 01/27/2015 Current

LAREDO, TX 78041

LAS PALMAS MEDICAL CENTER A

CAMPUS OF LPDS HEALTHCARE

000180 91552117761801 NORTH OREGON STREET 06/30/2021 09/12/1964 09/12/1964 03/23/2021 Current

EL PASO, TX 79902

LAS PALMAS REHABILITATION

HOSPITAL A CAMPUS OF LPDS

HEALTHCARE

000180 9155772600300 WAYMORE 06/30/2021 11/17/2003 11/17/2003 07/03/2019 Current

EL PASO, TX 79902

LAVACA MEDICAL CENTER000527 36179836711400 NORTH TEXANA STREET 12/31/2021 02/01/1977 02/01/1977 11/16/2011 Current

HALLETTSVILLE, TX 77964

LEGENT HOSPITAL FOR SPECIAL

SURGERY

100224 97226510504100 MAPLESHADE LANE 11/30/2021 11/06/2013 11/06/2013 01/03/2019 Current

PLANO, TX 75075

LEGENT HOSPITAL OF EL PASO008608 91559842401416 GEORGE DIETER DRIVE 12/31/2021 01/01/2008 01/01/2008 05/15/2020 Current

EL PASO, TX 79936

LEGENT ORTHOPEDIC + SPINE100324 21087780005330 NORTH LOOP 1604 WEST 08/31/2021 08/31/2015 08/31/2015 01/03/2019 Current

SAN ANTONIO, TX 78249

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

LEGENT ORTHOPEDIC HOSPITAL008742 97281007001401 E TRINITY MILLS RD 01/31/2023 08/19/2019 08/19/2019 07/08/2020 Current

CARROLLTON, TX 75006

LIBERTY DAYTON REGIONAL MEDICAL

CENTER

100300 93633673161353 NORTH TRAVIS 09/30/2022 10/01/2014 10/01/2014 10/01/2014 Current

LIBERTY, TX 77575

LIFECARE HOSPITALS OF FT WORTH100502 81737060786201 OVERTON RIDGE BOULEVARD 09/30/2021 09/30/2019 09/30/2019 09/30/2019 Current

FORT WORTH, TX 76132

LIFECARE HOSPITALS OF NORTH

TEXAS - DALLAS

100502 21464096001950 RECORD CROSSING ROAD 09/30/2021 09/30/2019 09/30/2019 01/03/2020 Current

DALLAS, TX 75235

LIFECARE HOSPITALS OF PLANO100502 21447388226800 PRESTON ROAD 09/30/2021 09/30/2019 09/30/2019 09/30/2019 Current

PLANO, TX 75024

LILLIAN M HUDSPETH MEMORIAL

HOSPITAL

000147 3253872521308 HUDSPETH AVENUE 12/31/2022 01/01/1960 01/01/1960 12/20/2010 Current

SONORA, TX 76950

LIMESTONE MEDICAL CENTER000052 2547293281701 MCCLINTIC 02/28/2023 02/23/1973 02/23/1973 01/28/2011 Current

GROESBECK, TX 76642

LONGVIEW REGIONAL MEDICAL

CENTER

000525 90375818182901 NORTH FOURTH STREET 01/31/2022 06/01/1980 06/01/1980 08/08/2017 Current

LONGVIEW, TX 75605

LUBBOCK HEART & SURGICAL

HOSPITAL

100158 80668777774810 NORTH LOOP 289 06/30/2022 06/20/2012 06/20/2012 06/20/2012 Current

LUBBOCK, TX 79416

LUMBERTON HOSPITAL LLC100499 4092270520220 BLANCO STREET 12/31/2021 12/13/2019 12/13/2019 12/13/2019 Current

LUMBERTON, TX 77657

LYNN COUNTY HOSPITAL DISTRICT000192 80699845332600 LOCKWOOD 07/31/2021 01/04/1971 01/04/1971 08/01/1998 Current

TAHOKA, TX 79373

MARTIN COUNTY HOSPITAL DISTRICT100145 4326073200600 EAST I 20 04/30/2022 04/23/2012 04/23/2012 04/23/2012 Current

STANTON, TX 79782

MATAGORDA REGIONAL MEDICAL

CENTER

100019 9792456383104 7TH STREET 07/31/2023 07/20/2009 07/20/2009 07/20/2009 Current

BAY CITY, TX 77414

MAYHILL HOSPITAL100088 94023930002809 MAYHILL ROAD SOUTH 01/31/2023 01/13/2011 01/13/2011 11/22/2011 Current

DENTON, TX 76208

MCCAMEY HOSPITAL000240 43265286262500 HIGHWAY 305 SOUTH 05/31/2023 06/01/1967 06/01/1967 05/11/2021 Current

MCCAMEY, TX 79752

MEDICAL ARTS HOSPITAL100011 80687221832200 NORTH BRYAN AVENUE 05/31/2023 05/13/2009 05/13/2009 06/11/2018 Current

Page 23 of 456/10/2021

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

LAMESA, TX 79331

MEDICAL CENTER HOSPITAL000181 4326402413500 WEST 4TH STREET 11/30/2022 01/01/1960 01/01/1960 06/04/2013 Current

ODESSA, TX 79761

MEDICAL CITY ALLIANCE100288 81763911003101 N TARRANT PKWY 02/28/2023 02/05/2015 02/05/2015 04/20/2021 Current

FORT WORTH, TX 76177

MEDICAL CITY ARLINGTON000502 81746532413301 MATLOCK RD 05/31/2023 06/29/1964 06/29/1964 05/07/2021 Current

ARLINGTON, TX 76015

MEDICAL CITY DALLAS HOSPITAL000340 97256660007777 FOREST LN 05/31/2023 09/26/1974 09/26/1974 06/07/2021 Current

DALLAS, TX 75230

MEDICAL CITY DENTON000336 94038435353535 SOUTH I-35 EAST 05/31/2021 12/14/1973 12/14/1973 03/07/2017 Current

DENTON, TX 76210

MEDICAL CITY FORT WORTH000477 8173362100900 EIGHTH AVENUE 05/31/2022 06/02/1976 06/02/1976 05/26/2020 Current

FORT WORTH, TX 76104

MEDICAL CITY FRISCO A MEDICAL

CENTER OF PLANO FACILITY

000214 21461805005500 FRISCO SQUARE BLVD 05/31/2023 04/01/2016 04/01/2016 04/01/2016 Current

FRISCO, TX 75034

MEDICAL CITY HEART & SPINE

HOSPITALS

000340 972566621711970 NORTH CENTRAL EXPRESSWAY 05/31/2023 09/12/2019 09/12/2019 09/12/2019 Current

DALLAS, TX 75243

MEDICAL CITY LAS COLINAS000814 97296920006800 N MACARTHUR BLVD 07/31/2021 07/08/1997 07/08/1997 08/20/2020 Current

IRVING, TX 75039

MEDICAL CITY LEWISVILLE000394 4693702707500 W MAIN ST 05/31/2023 02/28/1976 02/28/1976 08/21/2020 Current

LEWISVILLE, TX 75057

MEDICAL CITY MCKINNEY000246 97254780014500 MEDICAL CENTER DR 05/31/2023 01/01/1960 01/01/1960 09/14/2020 Current

MCKINNEY, TX 75069

MEDICAL CITY NORTH HILLS000437 81725510004401 BOOTH CALLOWAY ROAD 05/31/2022 05/05/1961 05/05/1961 03/07/2017 Current

NORTH RICHLAND HILLS, TX 76180

MEDICAL CITY PLANO000214 97251911053901 W 15TH ST 05/31/2023 12/31/1974 12/31/1974 08/12/2020 Current

PLANO, TX 75075

MEDICAL CITY WEATHERFORD100400 6825821000713 E ANDERSON ST 09/30/2021 10/01/2017 10/01/2017 10/01/2017 Current

WEATHERFORD, TX 76086

MEDINA REGIONAL HOSPITAL100046 83042678383100 AVENUE E 07/31/2021 07/27/2009 07/27/2009 07/27/2009 Current

HONDO, TX 78861

MEMORIAL HERMANN - TEXAS

MEDICAL CENTER

000347 71370440006411 FANNIN 11/30/2022 01/01/1960 01/01/1960 11/16/2020 Current

Page 24 of 456/10/2021

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HOUSTON, TX 77030

MEMORIAL HERMANN CYPRESS

HOSPITAL

000347 346231400027800 NORTHWEST FREEWAY 11/30/2022 02/23/2017 02/23/2017 02/23/2017 Current

CYPRESS, TX 77433

MEMORIAL HERMANN GREATER

HEIGHTS HOSPITAL

000172 71386720001635 NORTH LOOP WEST 11/30/2021 11/29/1965 11/29/1965 10/14/2015 Current

HOUSTON, TX 77008

MEMORIAL HERMANN KATY

HOSPITAL

000534 281644700023900 KATY FREEWAY 09/30/2021 08/18/1981 08/18/1981 09/13/2019 Current

KATY, TX 77494

MEMORIAL HERMANN MEMORIAL

CITY MEDICAL CENTER

000302 7139323000921 GESSNER ROAD 12/31/2022 04/16/1971 04/16/1971 02/28/2019 Current

HOUSTON, TX 77024

MEMORIAL HERMANN NORTHEAST

HOSPITAL

008471 281540770018951 MEMORIAL NORTH 12/31/2022 01/01/2007 01/01/2007 11/12/2020 Current

HUMBLE, TX 77338

MEMORIAL HERMANN ORTHOPEDIC

AND SPINE HOSPITAL

000347 71331444445410 WEST LOOP SOUTH 11/30/2022 04/11/2015 04/11/2015 04/11/2015 Current

BELLAIRE, TX 77401

MEMORIAL HERMANN PEARLAND

HOSPITAL

000119 713413658016100 SOUTH FREEWAY 11/30/2022 03/04/2016 03/04/2016 03/04/2016 Current

PEARLAND, TX 77584

MEMORIAL HERMANN

REHABILITATION HOSPITAL KATY

100009 281579567821720 KINGSLAND BLVD, SUITE 102 04/30/2023 04/29/2009 04/29/2009 04/26/2021 Current

KATY, TX 77450

MEMORIAL HERMANN SOUTHEAST

HOSPITAL

000119 281929610011800 ASTORIA BOULEVARD 11/30/2022 11/30/1963 11/30/1963 08/27/2018 Current

HOUSTON, TX 77089

MEMORIAL HERMANN SOUTHWEST

HOSPITAL

000407 71345650007600 BEECHNUT 12/31/2021 12/22/1976 12/22/1976 10/04/2019 Current

HOUSTON, TX 77074

MEMORIAL HERMANN SPECIALTY

HOSPITAL KINGWOOD LLC

008591 2813124000300 KINGWOOD MEDICAL DRIVE 08/31/2021 08/31/2007 08/31/2007 07/12/2019 Current

KINGWOOD, TX 77339

MEMORIAL HERMANN SUGAR LAND

HOSPITAL

000609 281725520217500 WEST GRAND PARKWAY SOUTH 09/30/2022 08/01/1983 08/01/1983 10/14/2020 Current

SUGAR LAND, TX 77479

MEMORIAL HERMANN SURGICAL

HOSPITAL FIRST COLONY

100161 281243100016906 SOUTH WEST FREEWAY 09/30/2022 09/04/2012 09/04/2012 03/26/2014 Current

SUGAR LAND, TX 77479

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

MEMORIAL HERMANN THE

WOODLANDS MEDICAL CENTER

000615 71389723019250 PINECROFT 05/31/2022 01/21/1985 01/21/1985 08/29/2019 Current

THE WOODLANDS, TX 77380

MEMORIAL HOSPITAL000199 8069347801224 EAST SECOND STREET 09/30/2022 01/01/1960 01/01/1960 07/27/2020 Current

DUMAS, TX 79029

MEMORIAL HOSPITAL000103 83067275811110 N SARAH DEWITT DRIVE 08/31/2022 01/01/1960 01/01/1960 09/01/1998 Current

GONZALES, TX 78629

MEMORIAL HOSPITAL000113 4327585811209 NW 8TH STREET 02/28/2022 01/01/1960 01/01/1960 02/09/2018 Current

SEMINOLE, TX 79360

MEMORIAL MEDICAL CENTER000487 3615526713815 NORTH VIRGINIA STREET 01/31/2022 01/09/1960 01/09/1960 02/01/1998 Current

PORT LAVACA, TX 77979

MESQUITE REHABILITATION

INSTITUTE

100067 97221624001023 NORTH BELT LINE ROAD 08/31/2022 08/23/2010 08/23/2010 04/07/2016 Current

MESQUITE, TX 75149

MESQUITE SPECIALTY HOSPITAL008400 97221623001024 NORTH GALLOWAY AVENUE 09/30/2022 09/22/2006 09/22/2006 09/22/2006 Current

MESQUITE, TX 75149

METHODIST DALLAS MEDICAL

CENTER

000255 21494781811441 NORTH BECKLEY AVENUE 01/31/2022 01/01/1960 01/01/1960 11/20/2020 Current

DALLAS, TX 75203

METHODIST AMBULATORY SURGERY

HOSPITAL-NORTHWEST

000681 21057550809150 HUEBNER ROAD SUITE 100 12/31/2021 01/06/1992 01/06/1992 07/26/2018 Current

SAN ANTONIO, TX 78240

METHODIST CHARLTON MEDICAL

CENTER

000142 21494777773500 W WHEATLAND RD 11/30/2021 12/01/1975 12/01/1975 09/08/2020 Current

DALLAS, TX 75237

METHODIST HOSPITAL000154 21057540007700 FLOYD CURL DRIVE 01/31/2023 06/01/1963 06/01/1963 04/29/2021 Current

SAN ANTONIO, TX 78229

METHODIST HOSPITAL FOR SURGERY100075 469248390017101 DALLAS PARKWAY 10/31/2022 10/22/2010 10/22/2010 10/22/2010 Current

ADDISON, TX 75001

METHODIST HOSPITAL SOUTH100391 83076935151905 HIGHWAY 97 EAST 06/30/2023 07/01/2017 07/01/2017 07/01/2017 Current

JOURDANTON, TX 78026

METHODIST HOSPITAL STONE OAK

REHABILITATION CENTER

008741 210482300019126 STONEHUE 01/31/2023 06/30/2020 06/30/2020 11/03/2020 Current

SAN ANTONIO, TX 78258

METHODIST MANSFIELD MEDICAL

CENTER

008428 68224260002700 E BROAD ST 11/30/2022 11/29/2006 11/29/2006 10/13/2020 Current

MANSFIELD, TX 76063

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

METHODIST MCKINNEY HOSPITAL LLC100043 97256927008000 WEST ELDORADO PARKWAY 01/31/2022 01/21/2010 01/21/2010 09/26/2018 Current

MCKINNEY, TX 75070

METHODIST MIDLOTHIAN MEDICAL

CENTER

100529 46984620001201 EAST US HIGHWAY 287 11/30/2022 11/04/2020 11/04/2020 11/04/2020 Current

MIDLOTHIAN, TX 76065

METHODIST REHABILITATION

HOSPITAL

008620 97270886003020 WEST WHEATLAND ROAD 01/31/2022 01/18/2008 01/18/2008 08/27/2019 Current

DALLAS, TX 75237

METHODIST RICHARDSON MEDICAL

CENTER

100131 46920420002831 E PRES GEORGE BUSH HWY 10/31/2021 10/01/2011 10/01/2011 09/08/2020 Current

RICHARDSON, TX 75082

METHODIST RICHARDSON MEDICAL

CENTER CAMPUS FOR CONTINUING

CARE

100131 4692042000401 W CAMPBELL ROAD 10/31/2021 10/01/2011 10/01/2011 04/28/2014 Current

RICHARDSON, TX 75080

METHODIST SOUTHLAKE HOSPITAL100360 8178654400421 E STATE HWY 114 05/31/2022 05/16/2016 05/16/2016 05/16/2016 Current

SOUTHLAKE, TX 76092

METHODIST SPECIALTY &

TRANSPLANT HOSPITAL

000154 21057581108026 FLOYD CURL DRIVE 01/31/2023 07/01/2002 07/01/2002 02/01/2021 Current

SAN ANTONIO, TX 78229

METHODIST STONE OAK HOSPITAL008741 21063820001139 EAST SONTERRA BLVD 01/31/2023 01/02/2009 01/02/2009 12/07/2020 Current

SAN ANTONIO, TX 78258

METHODIST TEXSAN HOSPITAL, A

METHODIST HOSPITAL FACILITY

000154 21073680016700 IH-10 WEST 01/31/2023 01/31/2011 01/31/2011 01/31/2011 Current

SAN ANTONIO, TX 78201

METROPOLITAN METHODIST

HOSPITAL

000154 21075722001310 MCCULLOUGH AVENUE 01/31/2023 10/31/2001 10/31/2001 02/01/2021 Current

SAN ANTONIO, TX 78212

MID COAST MEDICAL CENTER -

CENTRAL

100090 2452422824200 W OLLIE ST 01/31/2023 01/01/2011 01/01/2011 01/12/2021 Current

LLANO, TX 78643

MID-JEFFERSON EXTENDED CARE

HOSPITAL

100341 40972687002600 HIGHWAY 365 12/31/2022 01/01/2015 01/01/2015 05/13/2019 Current

NEDERLAND, TX 77627

MID-JEFFERSON EXTENDED CARE

HOSPITAL OF BEAUMONT

100341 4097268700860 SOUTH EIGHTH STREET 12/31/2022 05/13/2019 05/13/2019 01/23/2020 Current

BEAUMONT, TX 77701

MIDLAND MEMORIAL HOSPITAL000452 4322211111400 ROSALIND REDFERN GROVER

PKWY

01/31/2023 01/08/1960 01/08/1960 11/30/2020 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

MIDLAND, TX 79701

MISSION REGIONAL MEDICAL CENTER000370 9563239103900 SOUTH BRYAN ROAD 09/30/2021 01/01/1960 01/01/1960 10/09/2007 Current

MISSION, TX 78572

MISSION TRAIL BAPTIST HOSPITAL000114 21029736003333 RESEARCH PLAZA 12/31/2022 06/14/2011 06/14/2011 06/14/2011 Current

SAN ANTONIO, TX 78235

MITCHELL COUNTY HOSPITAL000075 3257283431997 WEST I-20 09/30/2022 01/01/1960 01/01/1960 10/01/1998 Current

COLORADO CITY, TX 79512

MUENSTER MEMORIAL HOSPITAL000365 9407592271605 NORTH MAPLE STREET 07/31/2022 01/01/1964 01/01/1964 08/01/1998 Current

MUENSTER, TX 76252

MULESHOE AREA MEDICAL CENTER100303 8062724524708 SOUTH FIRST STREET 02/28/2023 03/01/2015 03/01/2015 03/01/2015 Current

MULESHOE, TX 79347

NACOGDOCHES MEDICAL CENTER000392 93656994814920 N. E. STALLINGS DRIVE 04/30/2023 01/29/1975 01/29/1975 05/31/2016 Current

NACOGDOCHES, TX 75965

NACOGDOCHES MEMORIAL HOSPITAL000478 93655951561204 NORTH MOUND STREET 12/31/2021 01/01/1960 01/01/1960 01/02/2020 Current

NACOGDOCHES, TX 75961

NAVARRO REGIONAL HOSPITAL000141 90365468053201 WEST HIGHWAY 22 01/31/2022 01/01/1960 01/01/1960 09/24/1999 Current

CORSICANA, TX 75110

NEW BRAUNFELS REGIONAL

REHABILITATION HOSPITAL

100101 83062567002041 SUNDANCE PARKWAY 07/31/2023 07/05/2011 07/05/2011 07/05/2011 Current

NEW BRAUNFELS, TX 78130

NEXUS SPECIALTY HOSPITAL -THE

WOODLANDS LTD

000795 28136403179182 SIX PINES DRIVE 04/30/2022 04/10/1995 04/10/1995 05/01/1998 Current

THE WOODLANDS, TX 77380

NEXUS SPECIALTY HOSPITAL -THE

WOODLANDS LTD-SHENANDOAH

CAMPUS

000795 2813640317123 VISION PARK BLVD 04/30/2022 07/14/2005 07/14/2005 07/14/2005 Current

SHENANDOAH, TX 77384

NH HOSPITAL100539 346418984217506 RED OAK DR 01/31/2023 01/04/2021 01/04/2021 03/31/2021 Current

HOUSTON, TX 77090

NOCONA GENERAL HOSPITAL000348 9408253235100 PARK ROAD 04/30/2023 04/23/1974 04/23/1974 04/10/2019 Current

NOCONA, TX 76255

NORTH AUSTIN MEDICAL CENTER008299 512901252912221 MOPAC EXPRESSWAY NORTH 06/30/2023 07/01/2005 07/01/2005 10/13/2020 Current

AUSTIN, TX 78758

NORTH CENTRAL BAPTIST HOSPITAL000114 2102974600520 MADISON OAK 12/31/2022 09/01/2006 09/01/2006 12/27/2010 Current

SAN ANTONIO, TX 78258

Page 28 of 456/10/2021

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

NORTH CENTRAL SURGICAL CENTER

LLP

008606 21426528109301 NORTH CENTRAL EXPRESSWAY

#100

12/31/2021 12/21/2007 12/21/2007 12/23/2019 Current

DALLAS, TX 75231

NORTH RUNNELS HOSPITAL000151 32575445537821 STATE HIGHWAY 153 11/30/2022 11/08/1973 11/08/1973 12/01/1998 Current

WINTERS, TX 79567

NORTH TEXAS MEDICAL CENTER100453 94066517511900 HOSPITAL BOULEVARD 11/30/2022 12/01/2018 12/01/2018 12/06/2018 Current

GAINESVILLE, TX 76240

NORTHEAST BAPTIST HOSPITAL000114 21029726008811 VILLAGE DRIVE 12/31/2022 09/01/2006 09/01/2006 12/27/2010 Current

SAN ANTONIO, TX 78217

NORTHEAST METHODIST HOSPITAL000154 210757700012412 JUDSON ROAD 01/31/2023 07/01/2002 07/01/2002 02/01/2021 Current

SAN ANTONIO, TX 78233

NORTHWEST HILLS SURGICAL

HOSPITAL

000794 51234619946818 AUSTIN CENTER BOULEVARD 03/31/2023 03/20/1995 03/20/1995 03/09/2021 Current

AUSTIN, TX 78731

NORTHWEST TEXAS HOSPITAL000318 80635410001501 S COULTER STREET 05/31/2023 01/01/1960 01/01/1960 04/06/2021 Current

AMARILLO, TX 79106

NORTHWEST TEXAS SURGERY

CENTER

000318 80635979993501 SONCY ROAD SUITE 118 05/31/2023 07/01/2015 07/01/2015 07/01/2015 Current

AMARILLO, TX 79119

OAKBEND MEDICAL CENTER000230 28134130001705 JACKSON STREET 05/31/2023 01/01/1960 01/01/1960 05/13/2019 Current

RICHMOND, TX 77469

OAKBEND MEDICAL CENTER000230 281341200022003 SOUTHWEST FREEWAY 05/31/2023 10/16/2009 10/16/2009 10/16/2009 Current

RICHMOND, TX 77469

OAKBEND MEDICAL CENTER -

WHARTON HOSPITAL CAMPUS

000230 281341481210141 HWY 59 ROAD 05/31/2023 04/27/2018 04/27/2018 04/27/2018 Current

WHARTON, TX 77488

OCHILTREE GENERAL HOSPITAL000098 80643536063101 GARRETT DRIVE 12/31/2021 12/15/1966 12/15/1966 01/01/1999 Current

PERRYTON, TX 79070

ODESSA REGIONAL MEDICAL CENTER000425 4325828000520 EAST SIXTH STREET 10/31/2022 04/15/1975 04/15/1975 12/11/2020 Current

ODESSA, TX 79761

ODESSA REGIONAL MEDICAL CENTER

SOUTH CAMPUS

000425 4325828000900 E 4TH STREET 10/31/2022 06/12/2015 06/12/2015 12/11/2020 Current

ODESSA, TX 79761

OTTO KAISER MEMORIAL HOSPITAL000357 83058334013349 S HIGHWAY 181 09/30/2022 09/15/1975 09/15/1975 10/01/1998 Current

KENEDY, TX 78119

OUR CHILDRENS HOUSE100383 21486767001340 EMPIRE CENTRAL DRIVE 02/28/2023 02/10/2017 02/10/2017 02/10/2017 Current

Page 29 of 456/10/2021

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DALLAS, TX 75247

PALACIOS COMMUNITY MEDICAL

CENTER

000574 3619722511311 GREEN AVENUE 01/31/2023 02/16/1960 02/16/1960 12/08/2010 Current

PALACIOS, TX 77465

PALESTINE REGIONAL MEDICAL

CENTER

000629 90373111842900 SOUTH LOOP 256 09/30/2022 12/14/1987 12/14/1987 12/29/2020 Current

PALESTINE, TX 75801

PALESTINE REGIONAL MEDICAL

CENTER - REHAB & PSYCHIATRIC

CAMPUS

000629 90373110004000 SOUTH LOOP 256 09/30/2022 11/25/2002 11/25/2002 10/18/2001 Current

PALESTINE, TX 75801

PALO PINTO GENERAL HOSPITAL000034 9403257891400 SOUTHWEST 25TH AVENUE 07/31/2021 07/30/1970 07/30/1970 03/11/2014 Current

MINERAL WELLS, TX 76067

PAM REHABILITATION HOSPITAL OF

ALLEN

100203 97290820001001 RAINTREE CIRCLE 04/30/2023 04/08/2013 04/08/2013 07/02/2020 Current

ALLEN, TX 75013

PAM REHABILITATION HOSPITAL OF

BEAUMONT

100353 40983508353340 PLAZA 10 BOULEVARD 05/31/2022 06/01/2016 06/01/2016 06/01/2016 Current

BEAUMONT, TX 77707

PAM REHABILITATION HOSPITAL OF

CLEAR LAKE

100301 8322249500110 EAST MEDICAL CENTER

BOULEVARD

05/31/2023 05/07/2015 05/07/2015 08/29/2019 Current

WEBSTER, TX 77598

PAM REHABILITATION HOSPITAL OF

CLEAR LAKE - NORTH CAMPUS

100301 2812861500655 E MEDICAL CENTER BLVD 05/31/2023 07/31/2019 07/31/2019 07/31/2019 Current

WEBSTER, TX 77598

PAM REHABILITATION HOSPITAL OF

CORPUS CHRISTI

100423 3615000600345 S WATER ST 03/31/2022 03/29/2018 03/29/2018 03/29/2018 Current

CORPUS CHRISTI, TX 78401

PAM REHABILITATION HOSPITAL OF

HUMBLE

100301 281964660018839 MCKAY BLVD 05/31/2023 07/31/2019 07/31/2019 07/31/2019 Current

HUMBLE, TX 77338

PAM REHABILITATION HOSPITAL OF

RICHARDSON

100203 4698729200401 W CAMPBELL RD 5TH FLOOR 04/30/2023 07/02/2020 07/02/2020 07/02/2020 Current

RICHARDSON, TX 75080

PAM REHABILITATION HOSPITAL OF

ROUND ROCK

100451 7377089800351 SETON PARKWAY 11/30/2022 11/05/2018 11/05/2018 11/05/2018 Current

ROUND ROCK, TX 78665

PAM REHABILITATION HOSPITAL OF

VICTORIA

100229 3618947830101 JAMES COLEMAN DRIVE 12/31/2021 12/19/2013 12/19/2013 04/13/2016 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

VICTORIA, TX 77904

PAM SPECIALTY HOSPITAL OF CORPUS

CHRISTI BAYFRONT

100280 3615000565345 S WATER ST 3RD FLOOR 11/30/2022 04/12/2018 04/12/2018 01/22/2019 Current

CORPUS CHRISTI, TX 78401

PAM SPECIALTY HOSPITAL OF CORPUS

CHRISTI NORTH

100280 3618813223600 ELIZABETH STREET 3RD FLOOR 11/30/2022 11/03/2014 11/03/2014 04/12/2018 Current

CORPUS CHRISTI, TX 78404

PAM SPECIALTY HOSPITAL OF LUFKIN100442 93689973501201 W FRANK AVE 5TH AND 6TH

FLOORS

06/30/2022 07/01/2018 07/01/2018 07/24/2018 Current

LUFKIN, TX 75904

PAM SPECIALTY HOSPITAL OF LULING008482 8308758400200 MEMORIAL DRIVE 12/31/2022 12/17/2006 12/17/2006 04/13/2016 Current

LULING, TX 78648

PAM SPECIALTY HOSPITAL OF NEW

BRAUNFELS

100124 83062776001445 HANZ DRIVE 08/31/2021 08/17/2011 08/17/2011 08/28/2020 Current

NEW BRAUNFELS, TX 78130

PAM SPECIALTY HOSPITAL OF SAN

ANTONIO

100381 21060046005418 N LOOP 1604 WEST 01/31/2023 01/20/2017 01/20/2017 01/20/2017 Current

SAN ANTONIO, TX 78249

PAM SPECIALTY HOSPITAL OF SAN

ANTONIO MEDICAL CENTER

100496 71773196608902 FLOYD CURL DRIVE 09/30/2021 09/30/2019 09/30/2019 09/30/2019 Current

SAN ANTONIO, TX 78240

PAM SPECIALTY HOSPITAL OF

TEXARKANA NORTH

100278 90361476002400 ST MICHAEL DRIVE 2ND FLOOR 11/30/2022 11/03/2014 11/03/2014 01/29/2018 Current

TEXARKANA, TX 75503

PAM SPECIALTY HOSPITAL OF

VICTORIA NORTH

008481 3615766200102 MEDICAL DRIVE 12/31/2022 12/13/2006 12/13/2006 12/17/2020 Current

VICTORIA, TX 77904

PAM SPECIALTY HOSPITAL OF

VICTORIA SOUTH

100219 3614857300506 EAST SAN ANTONIO STREET 3RD

FLOOR

09/30/2021 09/25/2013 09/25/2013 04/13/2016 Current

VICTORIA, TX 77901

PAM SPECIALTY HOSPITAL OF

VICTORIA SOUTHEAST

008481 36123719572701 HOSPITAL DR 6TH FLOOR 12/31/2022 09/18/2019 09/18/2019 09/18/2019 Current

VICTORIA, TX 77901

PAMPA REGIONAL MEDICAL CENTER100154 8066653721ONE MEDICAL PLAZA 06/30/2022 06/08/2012 06/08/2012 02/26/2019 Current

PAMPA, TX 79065

PARIS REGIONAL MEDICAL CENTER

NORTH CAMPUS

000095 9037371111865 DESHONG DRIVE 12/31/2022 08/05/2001 08/05/2001 11/13/2020 Current

PARIS, TX 75460

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

PARKLAND MEMORIAL HOSPITAL000474 21459003565200 - 5201 HARRY HINES

BOULEVARD

06/30/2021 06/10/1960 06/10/1960 08/23/2019 Current

DALLAS, TX 75235

PARKVIEW HOSPITAL000116 8068265581901 SWEETWATER STREET 05/31/2023 05/10/1965 05/10/1965 03/23/2021 Current

WHEELER, TX 79096

PARKVIEW REGIONAL HOSPITAL000505 2545625332600 SOUTH BONHAM 06/30/2022 01/16/1963 01/16/1963 07/01/1998 Current

MEXIA, TX 76667

PARMER MEDICAL CENTER000200 80625027541307 CLEVELAND STREET 02/28/2023 01/01/1960 01/01/1960 01/31/2011 Current

FRIONA, TX 79035

PECOS COUNTY MEMORIAL HOSPITAL000356 4323364201387 WEST I H 10 07/31/2021 01/01/1960 01/01/1960 02/26/2019 Current

FORT STOCKTON, TX 79735

PERMIAN REGIONAL MEDICAL

CENTER

000187 4324642103720 HOSPITAL DRIVE 05/31/2022 06/25/1962 06/25/1962 06/09/2021 Current

ANDREWS, TX 79714

PETERSON REGIONAL MEDICAL

CENTER

008642 8308964200551 HILL COUNTRY DRIVE 04/30/2022 04/08/2008 04/08/2008 04/08/2008 Current

KERRVILLE, TX 78028

PHYSICIANS SURGICAL

HOSPITAL-PANHANDLE CAMPUS

008529 80621202477100 WEST 9TH AVENUE 06/30/2023 06/01/2007 06/01/2007 06/01/2007 Current

AMARILLO, TX 79106

PHYSICIANS SURGICAL

HOSPITAL-QUAIL CREEK CAMPUS

008529 80635461006819 PLUM CREEK DRIVE 06/30/2023 06/01/2007 06/01/2007 03/27/2019 Current

AMARILLO, TX 79124

PLAINS MEMORIAL HOSPITAL000260 8066472191310 WEST HALSELL 05/31/2023 05/08/1964 05/08/1964 04/06/2021 Current

DIMMITT, TX 79027

PLANO SURGICAL HOSPITAL100501 97282026002301 MARSH LANE 11/30/2021 11/25/2019 11/25/2019 11/25/2019 Current

PLANO, TX 75093

PREMIER SPECIALTY HOSPITAL OF EL

PASO

100308 91554518232311 NORTH OREGON STREET 03/31/2023 04/01/2015 04/01/2015 04/17/2019 Current

EL PASO, TX 79902

PROVIDENCE HOSPITAL000301 9566935000230 CALLE DEL NORTE 05/31/2022 06/29/2007 06/29/2007 05/20/2020 Current

LAREDO, TX 78041

RANKIN COUNTY HOSPITAL DISTRICT100311 43269312001611 SPUR 576 (BROADWAY STREET) 07/31/2023 07/06/2015 07/06/2015 06/01/2021 Current

RANKIN, TX 79778

REAGAN MEMORIAL HOSPITAL100367 32588425611300 N MAIN AVE 09/30/2022 09/16/2016 09/16/2016 09/08/2020 Current

BIG LAKE, TX 76932

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

REBA MCENTIRE CENTER FOR

REHABILITATION

008470 90341610001200 REBA MCENTIRE LANE 12/31/2022 01/01/2007 01/01/2007 01/03/2011 Current

DENISON, TX 75020

REEVES COUNTY HOSPITAL000367 43244735512323 TEXAS STREET 11/30/2022 02/21/1978 02/21/1978 01/08/2004 Current

PECOS, TX 79772

REFUGIO COUNTY MEMORIAL

HOSPITAL DISTRICT

000368 3615262321107 SWIFT STREET 09/30/2021 01/01/1960 01/01/1960 01/14/2020 Current

REFUGIO, TX 78377

REHAB CENTER AT RENAISSANCE007971 95636263255403 DOCTORS DRIVE 07/31/2022 02/21/2006 02/21/2006 07/13/2020 Current

EDINBURG, TX 78539

RESOLUTE HEALTH100255 8305006602555 CREEKSIDE CROSSING 04/30/2022 04/24/2014 04/24/2014 04/24/2014 Current

NEW BRAUNFELS, TX 78130

RICE MEDICAL CENTER100136 9792345571600 SOUTH AUSTIN ROAD 12/31/2021 12/01/2009 12/01/2009 03/09/2012 Current

EAGLE LAKE, TX 77434

RIO GRANDE REGIONAL HOSPITAL000601 9566326000101 E RIDGE ROAD 12/31/2021 09/13/1982 09/13/1982 05/01/2019 Current

MCALLEN, TX 78503

RIVER OAKS HOSPITALS & CLINICS100344 71333038874200 TWELVE OAKS DRIVE 01/31/2022 10/22/2019 10/22/2019 10/22/2019 Current

HOUSTON, TX 77027

ROLLING PLAINS MEMORIAL

HOSPITAL

000471 3252351701200 EAST ARIZONA 05/31/2022 06/01/1976 06/01/1976 09/19/2016 Current

SWEETWATER, TX 79556

ROUND ROCK MEDICAL CENTER000608 51234110002400 ROUND ROCK AVENUE 04/30/2023 08/31/1983 08/31/1983 06/03/2021 Current

ROUND ROCK, TX 78681

SABINE COUNTY HOSPITAL008645 40978733002301 WORTH ST 02/28/2022 02/25/2008 02/25/2008 02/27/2020 Current

HEMPHILL, TX 75948

SAINT CAMILLUS MEDICAL CENTER100361 81751937001612 HURST TOWN CENTER DR 07/31/2022 07/19/2016 07/19/2016 07/19/2016 Current

HURST, TX 76054

SCENIC MOUNTAIN MEDICAL CENTER,

A STEWARD FAMILY HOSPITAL

100463 43226849031601 WEST ELEVENTH PLACE 04/30/2023 04/13/2019 04/13/2019 04/13/2019 Current

BIG SPRING, TX 79720

SCHLEICHER COUNTY MEDICAL

CENTER

100184 3258532507102 NORTH HIGHWAY 277 02/28/2023 02/06/2013 02/06/2013 02/06/2013 Current

ELDORADO, TX 76936

SE TEXAS ER AND HOSPITAL100004 281883550019211 MCKAY BLVD 04/30/2023 04/09/2009 04/09/2009 04/18/2019 Current

HUMBLE, TX 77338

SELECT REHABILITATION HOSPITAL OF

DENTON

008715 94029765002620 SCRIPTURE STREET 11/30/2022 11/05/2008 11/05/2008 11/05/2008 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

DENTON, TX 76201

SELECT SPECIALTY HOSPITAL -

DALLAS

000672 46989214002329 PARKER RD 07/31/2023 03/28/1991 03/28/1991 06/09/2021 Current

CARROLLTON, TX 75010

SELECT SPECIALTY HOSPITAL -

DALLAS (DOWNTOWN)

100276 97222700933500 GASTON AVENUE 3RD AND 4TH

FLOORS

11/30/2022 11/10/2014 11/10/2014 03/09/2017 Current

DALLAS, TX 75246

SELECT SPECIALTY

HOSPITAL-LONGVIEW, INC.

007946 9033151105700 EAST MARSHALL AVENUE 1ST

AND GROUND FLOORS

05/31/2023 05/20/2003 05/20/2003 05/06/2019 Current

LONGVIEW, TX 75601

SETON MEDICAL CENTER HARKER

HEIGHTS

100149 2546900900850 WEST CENTRAL TEXAS

EXPRESSWAY

05/31/2022 05/07/2012 05/07/2012 05/07/2012 Current

HARKER HEIGHTS, TX 76548

SEYMOUR HOSPITAL000546 9408895572200 STADIUM DRIVE 11/30/2021 08/10/1969 08/10/1969 10/15/2019 Current

SEYMOUR, TX 76380

SHAMROCK GENERAL HOSPITAL000571 80625621141000 SOUTH MAIN 02/28/2022 06/01/1968 06/01/1968 03/01/1998 Current

SHAMROCK, TX 79079

SHANNON MEDICAL CENTER000168 3256536741120 E HARRIS AVE 08/31/2021 01/01/1960 01/01/1960 02/23/2021 Current

SAN ANGELO, TX 76903

SHANNON MEDICAL CENTER SOUTH000168 32594995113501 KNICKERBOCKER RD 08/31/2021 10/24/2020 10/24/2020 11/03/2020 Current

SAN ANGELO, TX 76904

SHANNON MEDICAL CENTER ST

JOHNS CAMPUS

000168 32565367412018 PULLIAM STREET 08/31/2021 01/01/1999 01/01/1999 08/05/2019 Current

SAN ANGELO, TX 76905

SHANNON REHABILITATION HOSPITAL

AN AFFILIATE OF ENCOMPASS HEALTH

100537 32528440006046 APPALOOSA TRAIL 03/31/2023 03/16/2021 03/16/2021 03/16/2021 Current

SAN ANGELO, TX 76901

SHRINERS HOSPITAL FOR CHILDREN -

GALVESTON

000247 4097706600815 MARKET STREET 03/31/2022 03/20/1966 03/20/1966 04/01/1998 Current

GALVESTON, TX 77550

SOLARA SPECIALTY HOSPITALS

HARLINGEN

008407 9564259600508 VICTORIA LANE 10/31/2022 10/06/2006 10/06/2006 10/26/2020 Current

HARLINGEN, TX 78550

SOLARA SPECIALTY HOSPITALS

HARLINGEN - BROWNSVILLE

008407 9565460808333 LORENALY DRIVE 10/31/2022 09/30/2007 09/30/2007 10/26/2020 Current

BROWNSVILLE, TX 78520

SOLARA SPECIALTY HOSPITALS

MCALLEN

100298 9566324880301 WEST EXPRESSWAY 83 8TH

FLOOR

01/31/2023 02/01/2015 02/01/2015 03/08/2019 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

MCALLEN, TX 78503

SOUTH PLAINS REHAB HOSPITAL, AN

AFFILIATE OF UMC AND ENCOMPASS

100461 80650735005406 COLGATE STREET 05/31/2023 05/06/2019 05/06/2019 05/06/2019 Current

LUBBOCK, TX 79416

SOUTH TEXAS HEALTH SYSTEM

BEHAVIORAL

000140 95638813002102 WEST TRENTON ROAD 02/28/2023 10/01/2007 10/01/2007 02/16/2011 Current

EDINBURG, TX 78503

SOUTH TEXAS HEALTH SYSTEM

EDINBURG

000140 95638860001102 WEST TRENTON ROAD 02/28/2023 02/04/1969 02/04/1969 03/13/2020 Current

EDINBURG, TX 78539

SOUTH TEXAS HEALTH SYSTEM

HEART

000140 95699420001900 SOUTH D STREET 02/28/2023 10/01/2007 10/01/2007 02/16/2011 Current

MCALLEN, TX 78503

SOUTH TEXAS HEALTH SYSTEM

MCALLEN

000140 9566324000301 WEST EXPRESSWAY 83 02/28/2023 10/01/2007 10/01/2007 02/16/2011 Current

MCALLEN, TX 78503

SOUTH TEXAS REHABILITATION

HOSPITAL

008211 9565546000425 EAST ALTON GLOOR BOULEVARD 03/31/2023 04/01/2005 04/01/2005 03/02/2011 Current

BROWNSVILLE, TX 78526

SOUTH TEXAS SPINE & SURGICAL

HOSPITAL

007868 210507409118600 NORTH HARDY OAK

BOULEVARD

08/31/2021 08/26/2002 08/26/2002 08/26/2002 Current

SAN ANTONIO, TX 78258

SOUTH TEXAS SURGICAL HOSPITAL100040 36199320006130 PARKWAY DRIVE 11/30/2021 11/19/2009 11/19/2009 11/19/2009 Current

CORPUS CHRISTI, TX 78413

SPRING HOSPITAL100520 346331404020635 KUYKENDAHL ROAD 06/30/2022 06/29/2020 06/29/2020 07/14/2020 Current

SPRING, TX 77379

ST DAVIDS GEORGETOWN HOSPITAL A

ST DAVIDS MEDICAL CENTER FACILI

000035 51294330002000 SCENIC DRIVE 04/30/2022 10/29/2008 10/29/2008 04/23/2020 Current

GEORGETOWN, TX 78626

ST DAVIDS MEDICAL CENTER000035 5124767111919 E 32ND STREET 04/30/2022 01/01/1960 01/01/1960 07/14/2020 Current

AUSTIN, TX 78705

ST DAVIDS REHABILITATION

HOSPITAL, A ST DAVIDS MEDICAL

CENTER

000035 51254451001005 EAST 32ND STREET 04/30/2022 01/15/2013 01/15/2013 01/15/2013 Current

AUSTIN, TX 78705

ST DAVIDS SOUTH AUSTIN MEDICAL

CENTER

000602 5124472211901 W BEN WHITE BLVD 04/30/2023 09/07/1982 09/07/1982 03/23/2021 Current

AUSTIN, TX 78704

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

ST DAVIDS SURGICAL HOSPITAL A

CAMPUS OF NORTH AUSTIN MEDICAL

CTR

008299 51290110001201 W LOUIS HENNA BLVD 06/30/2023 09/23/2016 09/23/2016 09/23/2016 Current

AUSTIN, TX 78681

ST JOSEPH MEDICAL CENTER008386 71375650071401 ST JOSEPH PARKWAY 08/31/2022 08/20/2006 08/20/2006 09/25/2019 Current

HOUSTON, TX 77002

ST JOSEPH REGIONAL HEALTH

CENTER

000002 97977637772801 FRANCISCAN DRIVE 01/31/2023 04/15/1971 04/15/1971 02/01/2021 Current

BRYAN, TX 77802

ST LUKES BAPTIST HOSPITAL000114 21029756007930 FLOYD CURL DRIVE 12/31/2022 09/01/2006 09/01/2006 12/27/2010 Current

SAN ANTONIO, TX 78229

ST LUKES HOSPITAL AT THE VINTAGE100235 832534510020171 CHASEWOOD PARK DR 12/31/2021 12/31/2013 12/31/2013 12/31/2013 Current

HOUSTON, TX 77070

ST LUKES LAKESIDE HOSPITAL LLC100035 936266911017400 ST LUKES WAY 09/30/2021 09/18/2009 09/18/2009 09/18/2009 Current

THE WOODLANDS, TX 77384

ST LUKES PATIENTS MEDICAL CENTER100081 71394870004600 EAST SAM HOUSTON PARKWAY

SOUTH

10/31/2022 10/29/2010 10/29/2010 12/27/2010 Current

PASADENA, TX 77505

ST LUKES SUGAR LAND HOSPITAL100134 28163770001317 LAKE POINTE PARKWAY 02/28/2022 02/09/2012 02/09/2012 03/21/2012 Current

SUGAR LAND, TX 77478

ST LUKES THE WOODLANDS HOSPITAL007931 936266200017200 ST LUKES WAY 03/31/2022 03/10/2003 03/10/2003 07/22/2019 Current

THE WOODLANDS, TX 77384

ST MARKS MEDICAL CENTER008234 9792422102ONE ST MARKS PLACE 06/30/2023 07/01/2005 07/01/2005 07/01/2005 Current

LA GRANGE, TX 78945

ST MICHAELS ELITE HOSPITAL100488 281980435716000 SOUTHWEST FREEWAY SUITE

100

08/31/2021 08/31/2019 08/31/2019 08/31/2019 Current

SUGAR LAND, TX 77479

STARR COUNTY MEMORIAL HOSPITAL000393 9564875561128 NORTH FM ROAD 3167 08/31/2022 02/05/1975 02/05/1975 03/17/2006 Current

RIO GRANDE CITY, TX 78582

STAT SPECIALTY HOSPITAL100465 83049830002600 VETERANS BLVD 05/31/2021 05/15/2019 05/15/2019 05/15/2019 Current

DEL RIO, TX 78840

STAT SPECIALTY HOSPITAL OF EAGLE

PASS

100535 83052230002114 N VETERANS BLVD 12/31/2022 12/17/2020 12/17/2020 12/17/2020 Current

EAGLE PASS, TX 78852

STAT SPECIALTY HOSPITAL OF LAREDO100493 95679130002502 NE BOB BULLOCK LOOP 11/30/2021 11/14/2019 11/14/2019 11/14/2019 Current

LAREDO, TX 78045

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

STEPHENS MEMORIAL HOSPITAL100221 2545592241200 SOUTH GENEVA 09/30/2021 10/01/2013 10/01/2013 10/01/2013 Current

BRECKENRIDGE, TX 76424

STONEWALL MEMORIAL HOSPITAL000666 9409893551821 N BROADWAY 11/30/2021 09/16/1965 09/16/1965 12/01/1998 Current

ASPERMONT, TX 79502

SUGARLAND REHAB HOSPITAL100447 28176690027622 BRANFORD PL 09/30/2022 09/26/2018 09/26/2018 09/26/2018 Current

SUGAR LAND, TX 77479

SURGERY SPECIALTY HOSPITALS OF

AMERICA SOUTHEAST HOUSTON

006941 71337830004301-B VISTA 04/30/2022 04/16/1999 04/16/1999 08/11/2004 Current

PASADENA, TX 77504

SWEENY COMMUNITY HOSPITAL000178 9795481598305 NORTH MCKINNEY STREET 09/30/2021 03/29/1965 03/29/1965 10/01/1998 Current

SWEENY, TX 77480

SWISHER MEMORIAL HOSPITAL100122 8069953581539 SE 2ND ST 06/30/2023 06/01/2011 12/07/2011 04/16/2021 Current

TULIA, TX 79088

TEXARKANA EMERGENCY CENTER &

HOSPITAL

100519 71366005574646 COWHORN CREEK RD 07/31/2022 07/10/2020 07/10/2020 07/10/2020 Current

TEXARKANA, TX 75503

TEXAS CHILDRENS HOSPITAL000117 83282410006621 FANNIN STREET 01/31/2022 01/01/1960 01/01/1960 10/15/2020 Current

HOUSTON, TX 77030

TEXAS CHILDRENS HOSPITAL THE

WOODLANDS

000117 936267500017600 INTERSTATE 45 SOUTH 01/31/2022 03/22/2017 03/22/2017 03/22/2017 Current

THE WOODLANDS, TX 77384

TEXAS CHILDRENS HOSPITAL WEST

CAMPUS

000117 832227100018200 KATY FREEWAY 01/31/2022 02/21/2011 02/21/2011 02/21/2011 Current

HOUSTON, TX 77094

TEXAS HEALTH ARLINGTON

MEMORIAL HOSPITAL

000422 8179606535800 W RANDOL MILL RD 07/31/2021 01/06/1960 01/06/1960 09/21/2020 Current

ARLINGTON, TX 76012

TEXAS HEALTH CENTER FOR

DIAGNOSTICS & SURGERY PLANO

008153 97240327006020 WEST PARKER ROAD 12/31/2021 12/31/2004 12/31/2004 12/31/2004 Current

PLANO, TX 75093

TEXAS HEALTH HARRIS METHODIST

HOSPITAL ALLIANCE

100162 682212200010864 TEXAS HEALTH TRL 09/30/2022 09/05/2012 09/05/2012 02/25/2021 Current

FORT WORTH, TX 76244

TEXAS HEALTH HARRIS METHODIST

HOSPITAL AZLE

000469 8174448600108 DENVER TRL 10/31/2022 05/05/1961 05/05/1961 09/21/2020 Current

AZLE, TX 76020

TEXAS HEALTH HARRIS METHODIST

HOSPITAL CLEBURNE

000323 8176412551201 WALLS DRIVE 05/31/2022 01/01/1960 01/01/1960 06/01/1998 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

CLEBURNE, TX 76033

TEXAS HEALTH HARRIS METHODIST

HOSPITAL FORT WORTH

000235 81725020001301 PENNSYLVANIA AVE 02/28/2022 01/01/1960 01/01/1960 09/21/2020 Current

FORT WORTH, TX 76104

TEXAS HEALTH HARRIS METHODIST

HOSPITAL HURST-EULESS-BEDFORD

000182 81784846021600 HOSPITAL PKWY 05/31/2023 03/27/1973 03/27/1973 06/03/2021 Current

BEDFORD, TX 76022

TEXAS HEALTH HARRIS METHODIST

HOSPITAL SOUTHLAKE

008128 81774887801545 SOUTHLAKE BLVD 10/31/2021 10/07/2004 10/07/2004 08/25/2016 Current

SOUTHLAKE, TX 76092

TEXAS HEALTH HARRIS METHODIST

HOSPITAL SOUTHWEST FORT WORTH

000627 81743350006100 HARRIS PKWY 03/31/2022 10/20/1987 10/20/1987 10/12/2020 Current

FORT WORTH, TX 76132

TEXAS HEALTH HARRIS METHODIST

HOSPITAL STEPHENVILLE

000256 2549651500411 N BELKNAP ST 03/31/2023 01/01/1960 01/01/1960 09/21/2020 Current

STEPHENVILLE, TX 76401

TEXAS HEALTH HEART & VASCULAR

HOSPITAL ARLINGTON

100073 8179603500811 WRIGHT ST 10/31/2022 10/13/2010 10/13/2010 09/21/2020 Current

ARLINGTON, TX 76012

TEXAS HEALTH HOSPITAL CLEARFORK000627 81743370105400 CLEARFORK MAIN ST 03/31/2022 05/25/2016 05/25/2016 05/25/2016 Current

FORT WORTH, TX 76109

TEXAS HEALTH HOSPITAL FRISCO100500 469495200012400 DALLAS PKWY 12/31/2021 12/13/2019 12/13/2019 09/21/2020 Current

FRISCO, TX 75033

TEXAS HEALTH HOSPITAL MANSFIELD100524 68234150002300 LONE STAR ROAD 10/31/2022 10/30/2020 10/30/2020 10/30/2020 Current

MANSFIELD, TX 76063

TEXAS HEALTH HOSPITAL ROCKWALL008599 46969810003150 HORIZON ROAD 12/31/2021 12/06/2007 12/06/2007 03/05/2020 Current

ROCKWALL, TX 75032

TEXAS HEALTH HUGULEY HOSPITAL100157 817293911011801 SOUTH FREEWAY 05/31/2022 05/01/2012 05/01/2012 03/11/2020 Current

BURLESON, TX 76028

TEXAS HEALTH PRESBYTERIAN

HOSPITAL ALLEN

007242 97274710001105 CENTRAL EXPY N 11/30/2021 11/13/2000 11/13/2000 09/21/2020 Current

ALLEN, TX 75013

TEXAS HEALTH PRESBYTERIAN

HOSPITAL DALLAS

000431 21434567898200 WALNUT HILL LN 03/31/2022 04/01/1966 04/01/1966 09/21/2020 Current

DALLAS, TX 75231

TEXAS HEALTH PRESBYTERIAN

HOSPITAL DENTON

008208 94089871913000 I 35 NORTH 03/31/2023 04/01/2005 04/01/2005 09/21/2020 Current

DENTON, TX 76201

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

TEXAS HEALTH PRESBYTERIAN

HOSPITAL FLOWER MOUND

100056 46932270004400 LONG PRAIRIE ROAD 04/30/2022 04/22/2010 04/22/2010 04/21/2020 Current

FLOWER MOUND, TX 75028

TEXAS HEALTH PRESBYTERIAN

HOSPITAL KAUFMAN

000303 9729327200850 ED HALL DRIVE 12/31/2022 01/01/1960 01/01/1960 12/21/2010 Current

KAUFMAN, TX 75142

TEXAS HEALTH PRESBYTERIAN

HOSPITAL PLANO

000664 97298180006200 W PARKER RD 12/31/2021 01/01/1991 01/01/1991 09/21/2020 Current

PLANO, TX 75093

TEXAS HEALTH SPECIALTY HOSPITAL

FORT WORTH

000652 81725055001301 PENNSYLVANIA AVENUE 4TH

FLOOR

09/30/2021 09/14/1989 09/14/1989 10/01/1998 Current

FORT WORTH, TX 76104

TEXAS INSTITUTE FOR SURGERY AT

TEXAS HEALTH PRESBYTERIAN

DALLAS

008131 21464753007115 GREENVILLE AVENUE 10/31/2022 10/29/2004 10/29/2004 10/29/2004 Current

DALLAS, TX 75231

TEXAS NEUROREHAB CENTER000622 51244448351106 WEST DITTMAR BUILDING 9 10/31/2021 08/18/1986 08/18/1986 04/06/2011 Current

AUSTIN, TX 78745

TEXAS ORTHOPEDIC HOSPITAL000792 71379434987401 SOUTH MAIN 02/28/2023 02/07/1995 02/07/1995 01/07/2011 Current

HOUSTON, TX 77030

TEXAS REHABILITATION HOSPITAL OF

ARLINGTON

100307 6823046000900 W ARBROOK BLVD 06/30/2021 06/22/2015 06/22/2015 06/22/2015 Current

ARLINGTON, TX 76015

TEXAS REHABILITATION HOSPITAL OF

FORT WORTH

100095 8178203400425 ALABAMA AVENUE 03/31/2023 04/11/2011 04/11/2011 08/13/2013 Current

FORT WORTH, TX 76104

TEXAS REHABILITATION HOSPITAL OF

KELLER

100530 8175629700791 S MAIN STREET 11/30/2022 11/04/2020 11/04/2020 03/05/2021 Current

KELLER, TX 76248

TEXAS RURAL HOSPITALS100392 2815925410300 EAST CROCKETT 07/31/2021 07/03/2017 07/03/2017 11/27/2018 Current

CLEVELAND, TX 77327

TEXAS SCOTTISH RITE HOSPITAL FOR

CHILDREN

000054 21455950002222 WELBORN STREET 12/31/2021 12/28/1977 12/28/1977 01/01/1998 Current

DALLAS, TX 75219

TEXAS VISTA MEDICAL CENTER000228 21092120007400 BARLITE BOULEVARD 10/31/2021 05/04/1979 05/04/1979 02/12/2021 Current

SAN ANTONIO, TX 78224

TEXOMA MEDICAL CENTER008470 90341640005016 SOUTH US HIGHWAY 75 12/31/2022 12/23/2009 12/29/2009 02/26/2019 Current

DENISON, TX 75020

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

THE COLONY ER HOSPITAL100398 21446925004780 STATE HWY 121 09/30/2021 09/20/2017 09/20/2017 09/20/2017 Current

THE COLONY, TX 75056

THE CORPUS CHRISTI MEDICAL

CENTER - BAY AREA

000703 36176112007101 SOUTH PADRE ISLAND DRIVE 09/30/2022 09/15/1993 09/15/1993 09/15/2020 Current

CORPUS CHRISTI, TX 78412

THE CORPUS CHRISTI MEDICAL

CENTER - DOCTORS REGIONAL

000703 36176114003315 SOUTH ALAMEDA 09/30/2022 06/01/1998 06/01/1998 09/15/2020 Current

CORPUS CHRISTI, TX 78411

THE CORPUS CHRISTI MEDICAL

CENTER - NORTHWEST

000703 361767430013725 NORTHWEST BLVD 09/30/2022 08/01/2004 08/01/2004 09/15/2020 Current

CORPUS CHRISTI, TX 78410

THE CORPUS CHRISTI MEDICAL

CENTER - THE HEART HOSPITAL

000703 36176168007002 WILLIAMS DRIVE 09/30/2022 06/01/1998 06/01/1998 09/15/2020 Current

CORPUS CHRISTI, TX 78413

THE HOSPITAL AT WESTLAKE

MEDICAL CENTER

008228 51232700005656 BEE CAVES ROAD STE M-302 06/30/2023 06/13/2005 06/13/2005 06/13/2005 Current

AUSTIN, TX 78746

THE HOSPITALS OF PROVIDENCE EAST

CAMPUS

008650 91583220003280 JOE BATTLE BOULEVARD 05/31/2022 05/06/2008 05/06/2008 08/28/2015 Current

EL PASO, TX 79938

THE HOSPITALS OF PROVIDENCE

HORIZON CITY CAMPUS

100395 915407787813600 HORIZON BOULEVARD SUITE

100

08/31/2021 08/28/2017 08/28/2017 10/08/2018 Current

HORIZON CITY, TX 79928

THE HOSPITALS OF PROVIDENCE

MEMORIAL CAMPUS

000130 91557760112001 NORTH OREGON STREET 09/30/2021 01/01/1960 01/01/1960 08/31/2015 Current

EL PASO, TX 79902

THE HOSPITALS OF PROVIDENCE

NORTHEAST CAMPUS

100395 281292245011274 MCCOMBS STREET 08/31/2021 10/08/2018 10/08/2018 10/08/2018 Current

EL PASO, TX 79934

THE HOSPITALS OF PROVIDENCE

SIERRA CAMPUS

000266 91574740001625 MEDICAL CENTER DRIVE 11/30/2021 12/04/1975 12/04/1975 02/26/2020 Current

EL PASO, TX 79902

THE HOSPITALS OF PROVIDENCE

SPINE & PAIN MANAGEMENT CENTER

000266 91574713001755 CURIE DRIVE SUITE A 11/30/2021 02/12/2020 02/12/2020 02/12/2020 Current

EL PASO, TX 79902

THE HOSPITALS OF PROVIDENCE

TRANSMOUNTAIN CAMPUS

100376 91587781362000 TRANSMOUNTAIN RD 11/30/2022 11/15/2016 11/15/2016 04/01/2020 Current

EL PASO, TX 79911

THE MEDICAL CENTER OF SOUTHEAST

TEXAS

000464 40985359022555 JIMMY JOHNSON BLVD 07/31/2021 01/05/1960 01/05/1960 03/19/2018 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

PORT ARTHUR, TX 77640

THE MEDICAL CENTER OF SOUTHEAST

TEXAS BEAUMONT CAMPUS

000464 40985359026025 METROPOLITAN DR 07/31/2021 09/19/2015 09/19/2015 09/19/2015 Current

BEAUMONT, TX 77706

THE PHYSICIANS CENTRE HOSPITAL007175 97973139303131 UNIVERSITY DRIVE EAST 05/31/2022 05/03/2000 05/03/2000 04/20/2020 Current

BRYAN, TX 77802

THE WOMANS HOSPITAL OF TEXAS000007 71379012347600 FANNIN STREET 02/28/2022 06/01/1976 06/01/1976 12/30/2020 Current

HOUSTON, TX 77054

THROCKMORTON COUNTY MEMORIAL

HOSPITAL

000428 9408492151802 NORTH MINTER AVENUE 12/31/2021 01/01/1960 01/01/1960 01/01/1998 Current

THROCKMORTON, TX 76483

TIRR MEMORIAL HERMANN100189 71379950001333 MOURSUND STREET 01/31/2023 01/02/2013 03/04/2013 03/28/2014 Current

HOUSTON, TX 77030

TITUS REGIONAL MEDICAL CENTER000137 90357760002001 NORTH JEFFERSON 01/31/2022 01/01/1960 01/01/1960 02/01/1998 Current

MOUNT PLEASANT, TX 75455

TMC BEHAVIORAL HEALTH CENTER008470 90341630002601 CORNERSTONE DRIVE 12/31/2022 01/01/2007 01/01/2007 01/03/2011 Current

SHERMAN, TX 75090

TMC BONHAM HOSPITAL100191 9035838585504 LIPSCOMB 01/31/2023 01/01/2013 01/01/2013 01/22/2021 Current

BONHAM, TX 75418

TOPS SURGICAL SPECIALTY HOSPITAL000674 281943740017080 RED OAK DRIVE 09/30/2021 04/08/1991 04/08/1991 05/24/2016 Current

HOUSTON, TX 77090

TOWNSEN MEMORIAL HOSPITAL100396 28136990011475 FM 1960 BYPASS E 06/30/2021 07/01/2017 07/01/2017 07/01/2017 Current

HUMBLE, TX 77338

TRINITY HOSPITAL100403 71346110009430 OLD KATY ROAD SUITE 100 10/31/2021 10/27/2017 10/27/2017 10/27/2017 Current

HOUSTON, TX 77055

TRUSTED MEDICAL CENTERS

MANSFIELD

100466 81722548101710 HWY 287 N SUITE 300 05/31/2021 05/30/2019 05/30/2019 05/30/2019 Current

MANSFIELD, TX 76063

TRUSTPOINT REHABILITATION

HOSPITAL OF LUBBOCK

100330 80674922224302 PRINCETON STREET 06/30/2023 06/16/2015 06/16/2015 03/28/2017 Current

LUBBOCK, TX 79415

TYLER CONTINUE CARE HOSPITAL008065 9035314943800 E DAWSON 4TH FLOOR 05/31/2022 05/14/2004 05/14/2004 03/01/2007 Current

TYLER, TX 75701

TYLER COUNTY HOSPITAL000569 40928364001100 WEST BLUFF STREET 08/31/2022 02/15/1960 02/15/1960 09/01/1998 Current

WOODVILLE, TX 75979

UNITED MEMORIAL MEDICAL CENTER008450 2816188505510 WEST TIDWELL ROAD 06/30/2022 06/30/2006 06/30/2006 07/14/2020 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

HOUSTON, TX 77091

UNITED MEMORIAL MEDICAL CENTER

- NORTH HOSPITAL

008450 281453711016750 RED OAK DR 06/30/2022 09/01/2019 09/01/2019 09/01/2019 Current

HOUSTON, TX 77090

UNITED MEMORIAL MEDICAL CENTER

- SUGAR LAND HOSPITAL

008450 28123839001211 HWY 6 #70 06/30/2022 10/25/2019 10/25/2019 10/25/2019 Current

SUGAR LAND, TX 77478

UNITED REGIONAL HEALTH CARE

SYSTEM

000417 94076470001600 11TH STREET 05/31/2022 01/22/1998 01/22/1998 07/14/2020 Current

WICHITA FALLS, TX 76301

UNIVERSITY HOSPITAL SYSTEM000158 21035840004502 MEDICAL DRIVE 10/31/2021 11/01/1968 11/01/1968 04/22/2014 Current

SAN ANTONIO, TX 78229

UNIVERSITY MEDICAL CENTER000145 8067758200602 INDIANA AVENUE 11/30/2022 11/10/1977 11/10/1977 09/08/2020 Current

LUBBOCK, TX 79415

UNIVERSITY MEDICAL CENTER OF EL

PASO

000263 91554412004815 ALAMEDA AVENUE 02/28/2022 03/01/1963 03/01/1963 02/26/2020 Current

EL PASO, TX 79905

USMD HOSPITAL AT ARLINGTON007990 8174723400801 WEST I-20 09/30/2021 09/24/2003 09/24/2003 09/05/2019 Current

ARLINGTON, TX 76017

UT HEALTH EAST TEXAS ATHENS

HOSPITAL

100426 90367610002000 SOUTH PALESTINE STREET 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

ATHENS, TX 75751

UT HEALTH EAST TEXAS CARTHAGE

HOSPITAL

100427 9036933841409 COTTAGE ROAD 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

CARTHAGE, TX 75633

UT HEALTH EAST TEXAS HENDERSON

HOSPITAL

100428 9036577541300 WILSON STREET 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

HENDERSON, TX 75652

UT HEALTH EAST TEXAS

JACKSONVILLE HOSPITAL

100429 9035415083501 SOUTH RAGSDALE STREET 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

JACKSONVILLE, TX 75766

UT HEALTH EAST TEXAS LONG TERM

ACUTE CARE

100437 90359636001000 S BECKHAM AVENUE 5TH FLOOR 02/28/2022 03/01/2018 03/01/2018 05/24/2019 Current

TYLER, TX 75701

UT HEALTH EAST TEXAS PITTSBURG

HOSPITAL

100430 90394655002701 US HIGHWAY 271 NORTH 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

PITTSBURG, TX 75686

UT HEALTH EAST TEXAS QUITMAN

HOSPITAL

100431 9037636300117 N WINNSBORO STREET 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

QUITMAN, TX 75783

UT HEALTH EAST TEXAS

REHABILITATION HOSPITAL

100436 9035963258701 OLYMPIC PLAZA CIRCLE 02/28/2022 03/01/2018 03/01/2018 03/01/2018 Current

TYLER, TX 75701

UT HEALTH EAST TEXAS TYLER

REGIONAL HOSPITAL

100433 90359703511000 SOUTH BECKHAM AVENUE 02/28/2022 03/01/2018 03/01/2018 06/30/2020 Current

TYLER, TX 75701

UVALDE MEMORIAL HOSPITAL000063 83027862511025 GARNER FIELD ROAD 06/30/2022 01/01/1960 01/01/1960 04/26/2016 Current

UVALDE, TX 78801

VAL VERDE REGIONAL MEDICAL

CENTER

000462 8307758566801 BEDELL AVENUE 01/31/2023 01/13/1960 01/13/1960 01/20/2011 Current

DEL RIO, TX 78840

VALLEY BAPTIST MEDICAL CENTER100104 95638916742101 PEASE ST 09/30/2021 09/01/2011 09/01/2011 10/22/2019 Current

HARLINGEN, TX 78550

VALLEY BAPTIST MEDICAL CENTER -

BROWNSVILLE

100105 95669854211040 W JEFFERSON ST 09/30/2021 09/01/2011 09/01/2011 08/29/2019 Current

BROWNSVILLE, TX 78520

VALLEY BAPTIST MICRO-HOSPITAL

WESLACO

100104 95638917361021 W INTERSTATE 2 09/30/2021 10/22/2019 10/22/2019 10/22/2019 Current

WESLACO, TX 78596

VALLEY REGIONAL MEDICAL CENTER000019 9563507000100A E ALTON GLOOR BLVD 04/30/2022 06/13/1975 06/13/1975 03/11/2020 Current

BROWNSVILLE, TX 78526

VIBRA HOSPITAL OF AMARILLO100222 80646770007501 WALLACE BLVD 08/31/2021 09/01/2013 09/01/2013 01/28/2020 Current

AMARILLO, TX 79124

VIBRA HOSPITAL OF RICHARDSON100118 4693297300401 WEST CAMPBELL ROAD SUITE 300 11/30/2021 05/12/2016 05/12/2016 05/12/2016 Current

RICHARDSON, TX 75080

VIBRA REHABILITATION HOSPITAL OF

AMARILLO

100223 80646829007200 W 9TH STREET 08/31/2021 09/01/2013 09/01/2013 09/01/2013 Current

AMARILLO, TX 79106

VIBRA SPECIALTY HOSPITAL100118 97229811002700 WALKER WAY 11/30/2021 11/29/2011 11/29/2011 05/12/2016 Current

DESOTO, TX 75115

W J MANGOLD MEMORIAL HOSPITAL000010 8066523373320 NORTH MAIN STREET 08/31/2021 01/01/1960 01/01/1960 07/25/2019 Current

LOCKNEY, TX 79241

WADLEY REGIONAL MEDICAL CENTER100002 90379880001000 PINE 02/28/2023 03/01/2009 03/01/2009 12/11/2015 Current

TEXARKANA, TX 75501

WARD MEMORIAL HOSPITAL000468 4329432511406 SOUTH GARY STREET 04/30/2023 01/01/1960 01/01/1960 03/10/2004 Current

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

MONAHANS, TX 79756

WARM SPRINGS REHABILITATION

HOSPITAL OF KYLE

100261 51226208215980 KYLE PARKWAY 06/30/2022 06/26/2014 06/26/2014 06/26/2014 Current

KYLE, TX 78640

WARM SPRINGS REHABILITATION

HOSPITAL OF SAN ANTONIO

008446 21061601005101 MEDICAL DRIVE 11/30/2022 12/01/2006 12/01/2006 04/24/2012 Current

SAN ANTONIO, TX 78229

WARM SPRINGS REHABILITATION

HOSPITAL OF THOUSAND OAKS

008446 210581530014747 JONES MALTSBERGER ROAD 11/30/2022 03/01/2012 03/01/2012 04/01/2012 Current

SAN ANTONIO, TX 78247

WARM SPRINGS REHABILITATION

HOSPITAL OF WESTOVER HILLS

008446 210422879110323 STATE HWY 151 11/30/2022 04/24/2012 04/24/2012 04/24/2012 Current

SAN ANTONIO, TX 78251

WEATHERFORD REHABILITATION

HOSPITAL LLC

100328 6828030100703 EUREKA ST 10/31/2021 10/05/2015 10/05/2015 10/05/2015 Current

WEATHERFORD, TX 76086

WESLACO REGIONAL REHABILITATION

HOSPITAL

100297 9569692222906 SOUTH JAMES STREET 02/28/2023 02/27/2015 02/27/2015 02/27/2015 Current

WESLACO, TX 78596

WILBARGER GENERAL HOSPITAL000084 9405529351920 HILLCREST DRIVE 06/30/2023 06/12/1969 06/12/1969 04/24/2019 Current

VERNON, TX 76384

WILSON N JONES REGIONAL MEDICAL

CENTER

100066 9038704611500 N HIGHLAND AVE 04/30/2022 04/14/2010 04/14/2010 01/14/2020 Current

SHERMAN, TX 75092

WINKLER COUNTY MEMORIAL

HOSPITAL

100399 4325868299821 JEFFEE DRIVE 09/30/2021 10/01/2017 10/01/2017 10/03/2017 Current

KERMIT, TX 79745

WINNIE COMMUNITY HOSPITAL LLC007814 4092966375538 BROADWAY 12/31/2021 12/12/2001 12/12/2001 12/06/2019 Current

WINNIE, TX 77665

WISE HEALTH SURGICAL HOSPITAL100335 81750273003200 NORTH TARRANT PARKWAY 01/31/2022 01/04/2016 01/04/2016 07/10/2018 Current

FORT WORTH, TX 76177

WISE HEALTH SURGICAL HOSPITAL100335 94029328857218 CRAWFORD ROAD 01/31/2022 07/10/2018 07/10/2018 07/10/2018 Current

ARGYLE, TX 76226

WISE HEALTH SYSTEM000254 9406275921609 MEDICAL CENTER DRIVE 12/31/2022 05/13/2002 05/13/2002 07/19/2018 Current

DECATUR, TX 76234

WISE HEALTH SYSTEM000254 94062640012000 SOUTH FM 51 12/31/2022 09/05/1974 09/05/1974 12/21/2010 Current

DECATUR, TX 76234

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License Type Code: 6810 - Rank Code: ALL - Status Code(s): 20 - Mdf: G,S

Profession Roster Report

Order By Name

Hospitals

LIC# Selected Address(MA) Phone Status/Secondary StatusExpires Rank Date Status DateOrig. DateName

WOMENS HOSPITAL AT RENAISSANCE007971 95636256015502 SOUTH MC COLL 07/31/2022 09/14/2007 09/14/2007 07/13/2020 Current

EDINBURG, TX 78539

WOODLAND HEIGHTS MEDICAL

CENTER

000481 9366378501505 SOUTH JOHN REDDITT DRIVE 12/31/2021 01/19/1960 01/19/1960 12/16/2013 Current

LUFKIN, TX 75904

WOODLANDS SPECIALTY HOSPITAL

LLC

100265 281602816025440 I 45 NORTH 08/31/2022 08/11/2014 08/11/2014 08/11/2014 Current

THE WOODLANDS, TX 77386

YOAKUM COMMUNITY HOSPITAL000023 36129323211200 CARL RAMERT DRIVE 08/31/2022 01/01/1960 01/01/1960 01/14/2020 Current

YOAKUM, TX 77995

YOAKUM COUNTY HOSPITAL000485 8065922121412 MUSTANG AVENUE 10/31/2022 01/20/1960 01/20/1960 11/01/1998 Current

DENVER CITY, TX 79323

TOTAL - 640

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