Healthcare Provider Details

I. General information

NPI: 1487085478
Provider Name (Legal Business Name): MIDLAND COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N SYCAMORE ST
FORT STOCKTON TX
79735-4602
US

IV. Provider business mailing address

1401 BALLINGER ST
FT WORTH TX
76102-5903
US

V. Phone/Fax

Practice location:
  • Phone: 817-339-6177
  • Fax: 817-339-6178
Mailing address:
  • Phone: 817-632-1000
  • Fax: 817-924-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: PAUL RUSSELL MEYERS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 432-221-4877