Basic Information
| Provider Information | |||||||||
| NPI: | 1114970423 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BROWNWOOD HOSPITAL LP | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | ONE SOURCE HEALTH CENTER SAN SABBATH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 760 | ||||||||
| Address2: | |||||||||
| City: | BROWNWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256468541 | ||||||||
| FaxNumber: | 3256465459 | ||||||||
| Practice Location | |||||||||
| Address1: | 403 W WALLACE ST | ||||||||
| Address2: | |||||||||
| City: | SAN SABA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 768774433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256468541 | ||||||||
| FaxNumber: | 3256465459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HURLEY | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2144737000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.