Healthcare Provider Details

I. General information

NPI: 1043580293
Provider Name (Legal Business Name): CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 S ROSS STERLING
ANAHUAC TX
77514-0398
US

IV. Provider business mailing address

PO BOX 398
ANAHUAC TX
77514-0398
US

V. Phone/Fax

Practice location:
  • Phone: 409-267-2068
  • Fax:
Mailing address:
  • Phone: 409-267-4126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateTX

VIII. Authorized Official

Name: ROBERT PASCASIO
Title or Position: CEO
Credential:
Phone: 409-267-3143