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General NPI Number Information
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NPI Number | 1659535441
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Entity Type | Organization
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Legal Business Name | COUNTY OF THROCKMORTON
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 1325 1ST ST.
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City | GRAHAM
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State | TX
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Zip | 76450-3603
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Country | US
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Telephone | 940-549-8787
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Fax | 940-521-0355
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Provider Business Mailing Address
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Address Line | 4150 INTERNATIONAL PLAZA SUITE 600
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City | FORT WORTH
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State | TX
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Zip | 76109-4831
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Country | US
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Telephone | 817-348-8959
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Fax | 817-348-0466
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. KIRBY D GOBER
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Credential |
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Telephone | 940-849-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 114203
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License Number State | TX
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