Healthcare Provider Details

I. General information

NPI: 1689272932
Provider Name (Legal Business Name): FANNIN COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 10/29/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 LIPSCOMB ST
BONHAM TX
75418-4028
US

IV. Provider business mailing address

504 LIPSCOMB ST
BONHAM TX
75418-4028
US

V. Phone/Fax

Practice location:
  • Phone: 903-583-8585
  • Fax: 903-640-7600
Mailing address:
  • Phone: 903-583-8585
  • Fax: 903-640-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER ZERINGUE
Title or Position: CEO
Credential:
Phone: 903-640-7310