Healthcare Provider Details

I. General information

NPI: 1831691922
Provider Name (Legal Business Name): CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 WEST MAIN HIGHWAY 82
CLARKSVILLE TX
75426
US

IV. Provider business mailing address

1401 BALLINGER ST
FORT WORTH TX
76102-5905
US

V. Phone/Fax

Practice location:
  • Phone: 903-427-3821
  • Fax:
Mailing address:
  • Phone: 817-632-1000
  • Fax: 817-924-6665

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: MARK MCKENZIE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 817-632-1000