Healthcare Provider Details

I. General information

NPI: 1609814763
Provider Name (Legal Business Name): COMMUNITY GENERAL HOSPITAL OF DILLEY TEXAS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W MILLER ST
DILLEY TX
78017-3818
US

IV. Provider business mailing address

230 W MILLER ST
DILLEY TX
78017-3818
US

V. Phone/Fax

Practice location:
  • Phone: 830-965-2003
  • Fax:
Mailing address:
  • Phone: 830-965-2003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number000803
License Number StateTX

VIII. Authorized Official

Name: DR. TARIQ MAHMOOD
Title or Position: CEO
Credential: MD
Phone: 254-697-6591