MEDICARE: FORT DUNCAN MEDICAL CENTER LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	547	TX
2	282N00000X	General Acute Care Hospital	547	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770579591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT DUNCAN MEDICAL CENTER LP

Provider Business Mailing Address
First Line	:	3333 N FOSTER MALDONADO BLVD
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-5110
Country	:	US
Telephone Number	:	830-773-5321
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 N FOSTER MALDONADO BLVD
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-5110
Country	:	US
Telephone Number	:	830-773-5321
Fax Number	:

Authorized Official
Title or Position	:	CFO, SENIOR VP
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	01/24/2022

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