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General NPI Number Information
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NPI Number | 1184695785
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Entity Type | Organization
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Legal Business Name | JOURDANTON HOSPITAL CORPORATION
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 1905 HIGHWAY 97 E
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City | JOURDANTON
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State | TX
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Zip | 78026-1504
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Country | US
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Telephone | 830-769-3515
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Fax | 830-769-5264
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Provider Business Mailing Address
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Address Line | PO BOX 847974
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City | DALLAS
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State | TX
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Zip | 75284-7974
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Country | US
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Telephone | 830-769-3515
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Fax | 830-769-5264
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LAURIE J HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 000334
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License Number State | TX
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