Provider Demographics
NPI: | 1942773874 |
---|---|
Name: | PALACIOS COMMUNITY MEDICAL CENTER |
Entity type: | Organization |
Organization Name: | PALACIOS COMMUNITY MEDICAL CENTER |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | MAK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 713-569-7370 |
Mailing Address - Street 1: | 303 SANDY CORNER RD |
Mailing Address - Street 2: | |
Mailing Address - City: | EL CAMPO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77437-9535 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 979-543-5510 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 307 GREEN AVE |
Practice Address - Street 2: | |
Practice Address - City: | PALACIOS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77465-3213 |
Practice Address - Country: | US |
Practice Address - Phone: | 361-972-2000 |
Practice Address - Fax: | 361-972-2009 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-01-03 |
Last Update Date: | 2024-12-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |