Healthcare Provider Details

I. General information

NPI: 1053192245
Provider Name (Legal Business Name): COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10133 HWY 16N
COMANCHE TX
76442
US

IV. Provider business mailing address

10133 HWY 16N
COMANCHE TX
76442
US

V. Phone/Fax

Practice location:
  • Phone: 254-879-4970
  • Fax:
Mailing address:
  • Phone: 254-879-4970
  • Fax:

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: NIKKI STARK
Title or Position: COO
Credential:
Phone: 254-879-4970