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General NPI Number Information
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NPI Number | 1306828611
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Entity Type | Organization
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Legal Business Name | LLANO COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 102 E YOUNG ST
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City | LLANO
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State | TX
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Zip | 78643-1349
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Country | US
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Telephone | 325-247-4131
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Fax | 325-248-2099
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Provider Business Mailing Address
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Address Line | 200 W OLLIE
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City | LLANO
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State | TX
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Zip | 78643-2628
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Country | US
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Telephone | 325-247-5040
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Fax | 325-247-2801
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Authorized Official
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Title or Position | CEO
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Name | MR. KEVIN A LEEPER
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Credential |
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Telephone | 325-247-7868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | TX
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