Healthcare Provider Details

I. General information

NPI: 1336738095
Provider Name (Legal Business Name): CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S PRAIRIE ST
DAYTON TX
77535-2819
US

IV. Provider business mailing address

PO BOX 398
ANAHUAC TX
77514-0398
US

V. Phone/Fax

Practice location:
  • Phone: 409-267-3143
  • Fax:
Mailing address:
  • Phone: 409-267-3143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT PASCASIO
Title or Position: CEO
Credential:
Phone: 409-267-3143