Provider Demographics
NPI:1174533103
Name:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Entity type:Organization
Organization Name:DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-244-9267
Mailing Address - Street 1:206 E. 16TH ST
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-4802
Mailing Address - Country:US
Mailing Address - Phone:806-244-5668
Mailing Address - Fax:806-244-5912
Practice Address - Street 1:206 E. 16TH ST
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022
Practice Address - Country:US
Practice Address - Phone:806-244-5668
Practice Address - Fax:806-244-5912
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DALLAM HARTLEY COUNTIES HOSPITAL DIST. DBA COON MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-09
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000262261QR1300X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0019EZOtherBLUE CROSS BLUE SHIELD
TX103267102Other1ST CARE
TX144326902OtherMCD TX HLTH STEPS
TX0019EZOtherBC
TX144326901Medicaid
TX144326901Medicaid