Healthcare Provider Details

I. General information

NPI: 1952453946
Provider Name (Legal Business Name): MEDINA COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 STATE HIGHWAY 173 N
DEVINE TX
78016-4791
US

IV. Provider business mailing address

3100 AVENUE E
HONDO TX
78861-3534
US

V. Phone/Fax

Practice location:
  • Phone: 830-426-7444
  • Fax: 830-665-9586
Mailing address:
  • Phone: 830-426-7700
  • Fax: 830-426-7860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number100046
License Number StateTX

VIII. Authorized Official

Name: MR. KEVIN FROSCH
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 830-426-5001