Healthcare Provider Details

I. General information

NPI: 1396798583
Provider Name (Legal Business Name): JACK COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E JASPER ST
JACKSBORO TX
76458-1848
US

IV. Provider business mailing address

211 E JASPER ST
JACKSBORO TX
76458-1848
US

V. Phone/Fax

Practice location:
  • Phone: 940-567-2686
  • Fax: 940-567-5038
Mailing address:
  • Phone:
  • Fax:

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: MR. FRANK BEAMAN
Title or Position: CEO
Credential:
Phone: 940-567-6633