Basic Information
Provider Information
NPI: 1184233785
EntityType: 2
ReplacementNPI:  
OrganizationName: HENDRICK MEDICAL CENTER BROWNWOOD
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1900 PINE ST
Address2:  
City: ABILENE
State: TX
PostalCode: 796012432
CountryCode: US
TelephoneNumber: 3256702000
FaxNumber:  
Practice Location
Address1: 1501 BURNETT RD
Address2:  
City: BROWNWOOD
State: TX
PostalCode: 768018520
CountryCode: US
TelephoneNumber: 3256468541
FaxNumber: 3256465459
Other Information
ProviderEnumerationDate: 07/29/2020
LastUpdateDate: 10/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WALKER
AuthorizedOfficialFirstName: JEREMY
AuthorizedOfficialMiddleName: TYLER
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3256702182
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


Home