=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023173507
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STARR COUNTY HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2006
-----------------------------------------------------
Last Update Date | 03/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 640 E BRAVO BLVD
-----------------------------------------------------
City | ROMA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78584-5720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-849-2176
-----------------------------------------------------
Fax | 956-849-4155
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 78
-----------------------------------------------------
City | RIO GRANDE CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78582-0078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-849-0674
-----------------------------------------------------
Fax | 956-847-1777
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. THALIA H MUNOZ
-----------------------------------------------------
Credential | RN, MS
-----------------------------------------------------
Telephone | 956-487-5561
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------