Healthcare Provider Details

I. General information

NPI: 1770314825
Provider Name (Legal Business Name): FANNIN COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E W M WATSON BLVD
DAINGERFIELD TX
75638-2013
US

IV. Provider business mailing address

507 E W M WATSON BLVD
DAINGERFIELD TX
75638-2013
US

V. Phone/Fax

Practice location:
  • Phone: 903-645-3915
  • Fax: 903-645-7250
Mailing address:
  • Phone: 903-645-3915
  • Fax: 903-645-7250

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: DENVER SHEDDY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 903-583-1854