Healthcare Provider Details

I. General information

NPI: 1609213552
Provider Name (Legal Business Name): SCOTT & WHITE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2013
Last Update Date: 06/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 S 31ST ST
TEMPLE TX
76508-0001
US

IV. Provider business mailing address

206 GREENBRIAR ST
BELTON TX
76513-1506
US

V. Phone/Fax

Practice location:
  • Phone: 254-724-8797
  • Fax:
Mailing address:
  • Phone: 972-825-7449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. CURTIS MIRKES
Title or Position: PROGRAM DIRECTOR
Credential: D.O.
Phone: 254-724-7566