Healthcare Provider Details

I. General information

NPI: 1215545561
Provider Name (Legal Business Name): COMANCHE COUNTY MEDICAL CENTER COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N PATRICK ST
DUBLIN TX
76446-1918
US

IV. Provider business mailing address

10201 HIGHWAY 16
COMANCHE TX
76442-4462
US

V. Phone/Fax

Practice location:
  • Phone: 254-445-4900
  • Fax: 254-879-4991
Mailing address:
  • Phone: 254-879-4910
  • Fax: 254-879-4991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NIKKI STARK
Title or Position: DIRECTOR OF CLINIC OPERATIONS
Credential:
Phone: 254-879-4910