Provider Demographics
NPI:1487952677
Name:PARKER COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:PARKER COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BACUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-341-2520
Mailing Address - Street 1:1130 PECAN ST.
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086
Mailing Address - Country:US
Mailing Address - Phone:817-341-2520
Mailing Address - Fax:817-599-1241
Practice Address - Street 1:1130 PECAN DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5774
Practice Address - Country:US
Practice Address - Phone:817-341-2520
Practice Address - Fax:817-599-1241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPH0853OtherPTAN