Healthcare Provider Details

I. General information

NPI: 1922056993
Provider Name (Legal Business Name): PALO PINTO COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SW 25TH AVE
MINERAL WELLS TX
76067-8246
US

IV. Provider business mailing address

400 SW 25TH AVE
MINERAL WELLS TX
76067-8246
US

V. Phone/Fax

Practice location:
  • Phone: 940-325-7891
  • Fax: 940-328-7529
Mailing address:
  • Phone: 940-325-7891
  • Fax: 940-328-6523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number000034
License Number StateTX

VIII. Authorized Official

Name: DOUGLAS P SELSOR
Title or Position: CFO
Credential:
Phone: 940-325-7891