Healthcare Provider Details

I. General information

NPI: 1659366557
Provider Name (Legal Business Name): SCOTT & WHITE HOSPITAL - TAYLOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 MALLARD LN
TAYLOR TX
76574-1208
US

IV. Provider business mailing address

PO BOX 844658
DALLAS TX
75284-4658
US

V. Phone/Fax

Practice location:
  • Phone: 512-352-7611
  • Fax: 512-352-4734
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number44
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number44
License Number StateTX

VIII. Authorized Official

Name: JAY FOX
Title or Position: CEO
Credential:
Phone: 512-509-0409