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General NPI Number Information
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NPI Number | 1679518542
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Entity Type | Organization
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Legal Business Name | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 1507 WEST MAIN STREET
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City | GATESVILLE
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State | TX
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Zip | 76528
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Country | US
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Telephone | 254-248-6380
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Fax | 254-865-8605
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Provider Business Mailing Address
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Address Line | 402 E MAIN ST
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City | GATESVILLE
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State | TX
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Zip | 76528-1315
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Country | US
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Telephone | 254-248-6380
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Fax | 254-248-6369
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DAVID K BYROM
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Credential | CPA
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Telephone | 254-248-6301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001525
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License Number State | TX
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