Healthcare Provider Details

I. General information

NPI: 1184926867
Provider Name (Legal Business Name): METROPLEX ADVENTIST HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2010
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 N KEY AVE
LAMPASAS TX
76550-1106
US

IV. Provider business mailing address

2201 S CLEAR CREEK RD
KILLEEN TX
76549-4110
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-3682
  • Fax:
Mailing address:
  • Phone: 254-526-7523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: PENNY L JOHNSON
Title or Position: CFO
Credential:
Phone: 254-526-7523