Healthcare Provider Details

I. General information

NPI: 1396144614
Provider Name (Legal Business Name): BAYLOR COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BAILEY AVE
WICHITA FALLS TX
76301-6927
US

IV. Provider business mailing address

100 BAILEY AVE
WICHITA FALLS TX
76301-6927
US

V. Phone/Fax

Practice location:
  • Phone: 940-766-0279
  • Fax: 940-767-5637
Mailing address:
  • Phone: 940-766-0279
  • Fax: 940-767-5637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LESLIE HARDIN
Title or Position: CEO
Credential:
Phone: 940-889-5572