Healthcare Provider Details

I. General information

NPI: 1215574959
Provider Name (Legal Business Name): FRIO HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 FM W 117
DILLY TX
78017
US

IV. Provider business mailing address

200 S INTERSTATE 35
PEARSALL TX
78061-6601
US

V. Phone/Fax

Practice location:
  • Phone: 830-334-2058
  • Fax:
Mailing address:
  • Phone: 830-334-2058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MONICA ANN MARTINEZ
Title or Position: RURAL HEALTH CLINIC DIRECTOR
Credential:
Phone: 830-334-2058