Basic Information
Provider Information
NPI: 1710011382
EntityType: 2
ReplacementNPI:  
OrganizationName: TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE
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Mailing Information
Address1: 500 EAST BORDER
Address2:  
City: ARLINGTON
State: TX
PostalCode: 76010
CountryCode: US
TelephoneNumber: 8175708500
FaxNumber: 8175708199
Practice Location
Address1: 411 N. BELKNAP STREET
Address2:  
City: STEPHENVILLE
State: TX
PostalCode: 764013415
CountryCode: US
TelephoneNumber: 2549651556
FaxNumber: 2549651591
Other Information
ProviderEnumerationDate: 03/15/2007
LastUpdateDate: 11/11/2020
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AuthorizedOfficialLastName: CROSS
AuthorizedOfficialFirstName: CAROL
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AuthorizedOfficialTitleorPosition: DIRECTOR OF FINANCE
AuthorizedOfficialTelephone: 2549651556
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 11/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
281P00000X000256TXY HospitalsChronic Disease Hospital 

ID Information
IDTypeStateIssuerDescription
02523890105TX MEDICAID


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