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General NPI Number Information
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NPI Number | 1417063256
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Entity Type | Organization
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Legal Business Name | HUGULEY MEMORIAL MEDICAL CENTER
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 777 S BURLESON BLVD
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City | BURLESON
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State | TX
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Zip | 76028-4904
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Country | US
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Telephone | 817-426-2200
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Fax | 817-447-7100
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Provider Business Mailing Address
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Address Line | 777 S BURLESON BLVD
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City | BURLESON
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State | TX
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Zip | 76028-4904
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Country | US
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Telephone | 817-426-2200
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Fax | 817-447-7100
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Authorized Official
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Title or Position | CFO / VICE PRESIDENT
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Name | MRS. PENNY L. JOHNSON
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Credential |
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Telephone | 817-551-2704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 000476
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License Number State | TX
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