Healthcare Provider Details
I. General information
NPI: 1275339459
Provider Name (Legal Business Name): HORIZON EAGLE PASS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2114 N VETERANS BLVD
EAGLE PASS TX
78852-7718
US
IV. Provider business mailing address
PO BOX 790379
SAINT LOUIS MO
63179-0379
US
V. Phone/Fax
- Phone: 832-219-3147
- Fax:
- Phone: 832-219-3147
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
DARLEEN
CALLAHAN
Title or Position: VICE PRESIDENT, REVENUE CYCLE
Credential:
Phone: 607-437-7902