Healthcare Provider Details

I. General information

NPI: 1568082477
Provider Name (Legal Business Name): DIMMIT REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 HOSPITAL DR STE B
CARRIZO SPRINGS TX
78834-3847
US

IV. Provider business mailing address

PO BOX 1016
CARRIZO SPRINGS TX
78834-7016
US

V. Phone/Fax

Practice location:
  • Phone: 830-876-9458
  • Fax: 830-876-2411
Mailing address:
  • Phone: 830-876-9458
  • Fax: 830-876-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALMA MELENDEZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 830-876-2424