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General NPI Number Information
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NPI Number | 1558715201
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Entity Type | Organization
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Legal Business Name | ECTOR COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 6030 W UNIVERSITY BLVD
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City | ODESSA
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State | TX
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Zip | 79764-8530
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Country | US
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Telephone | 432-640-6600
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Fax | 432-640-4791
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Provider Business Mailing Address
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Address Line | 6030 W UNIVERSITY BLVD STE 100
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City | ODESSA
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State | TX
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Zip | 79764-8530
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Country | US
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Telephone | 432-640-6600
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Fax | 432-640-4776
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAVID GARCIA
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Credential |
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Telephone | 432-640-4868
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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 |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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