Healthcare Provider Details
I. General information
NPI: 1821268046
Provider Name (Legal Business Name): MEDICAL ARTS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 NORTH BRYAN AVENUE
LAMESA TX
79331-3145
US
IV. Provider business mailing address
1600 NORTH BRYAN AVENUE
LAMESA TX
79331-3145
US
V. Phone/Fax
- Phone: 806-872-2183
- Fax: 806-872-7943
- Phone: 806-872-2183
- Fax: 806-872-7943
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name: MS.
LETHA
HUGHES
Title or Position: COO
Credential:
Phone: 806-872-2183