Healthcare Provider Details

I. General information

NPI: 1952853194
Provider Name (Legal Business Name): DECATUR HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2016
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 15TH ST
BRIDGEPORT TX
76426-2055
US

IV. Provider business mailing address

2108 15TH ST
BRIDGEPORT TX
76426-2055
US

V. Phone/Fax

Practice location:
  • Phone: 940-683-8500
  • Fax: 940-683-5023
Mailing address:
  • Phone: 940-683-8500
  • Fax: 940-683-5023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN TODD SCROGGINS
Title or Position: CEO
Credential:
Phone: 940-900-4348