Healthcare Provider Details

I. General information

NPI: 1184675340
Provider Name (Legal Business Name): ELGIN MEDICAL CENTER,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 2ND ST
ELGIN TX
78621-2225
US

IV. Provider business mailing address

209 E 2ND ST
ELGIN TX
78621-2225
US

V. Phone/Fax

Practice location:
  • Phone: 512-285-3315
  • Fax: 512-281-2872
Mailing address:
  • Phone: 512-285-3315
  • Fax: 512-281-2872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberF3048
License Number StateTX

VIII. Authorized Official

Name: DR. WILLIAM T BIEL
Title or Position: PARTNER
Credential: MD
Phone: 512-285-3315