Healthcare Provider Details

I. General information

NPI: 1750345088
Provider Name (Legal Business Name): ECTOR COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 W CLEMENTS ST
ODESSA TX
79763-4601
US

IV. Provider business mailing address

840 W CLEMENTS ST
ODESSA TX
79763-4601
US

V. Phone/Fax

Practice location:
  • Phone: 432-333-3888
  • Fax: 432-640-4864
Mailing address:
  • Phone: 432-640-4860
  • Fax: 432-640-4864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DAVID GARCIA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 432-640-4860