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General NPI Number Information
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NPI Number | 1578547345
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Entity Type | Organization
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Legal Business Name | MEMORIAL MEDICAL CENTER SAN AUGUSTINE
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 511 E HOSPITAL ST
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City | SAN AUGUSTINE
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State | TX
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Zip | 75972-2121
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Country | US
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Telephone | 936-275-3446
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Fax | 936-275-9921
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Provider Business Mailing Address
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Address Line | P O BOX 1447
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City | LUFKIN
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State | TX
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Zip | 75902-1447
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Country | US
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Telephone | 936-275-3446
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Fax | 936-275-9921
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Authorized Official
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Title or Position | REIMBURSEMENT ANALYST
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Name | MEGAN GLASS
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Credential |
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Telephone | 936-639-7661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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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 | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number |
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License Number State |
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