Healthcare Provider Details

I. General information

NPI: 1821549502
Provider Name (Legal Business Name): DIMMIT REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 HOSPITAL DR
CARRIZO SPRINGS TX
78834-3836
US

IV. Provider business mailing address

704 HOSPITAL DR
CARRIZO SPRINGS TX
78834-3836
US

V. Phone/Fax

Practice location:
  • Phone: 830-876-2424
  • Fax: 830-876-5774
Mailing address:
  • Phone: 830-876-2424
  • Fax: 830-876-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES E BUCKNER JR.
Title or Position: CEO
Credential:
Phone: 830-876-2424