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General NPI Number Information
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NPI Number | 1730242538
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Entity Type | Organization
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Legal Business Name | DECATUR HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 2150 S FM 51
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City | DECATUR
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State | TX
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Zip | 76234
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Country | US
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Telephone | 940-626-5100
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Fax | 940-626-1750
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Provider Business Mailing Address
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Address Line | 2000 S FM 51
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City | DECATUR
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State | TX
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Zip | 76234
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Country | US
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Telephone | 940-626-1700
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Fax | 940-626-1750
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Authorized Official
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Title or Position | CEO ADMINISTRATOR
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Name | JASON LANCE WREN
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Credential |
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Telephone | 940-627-8671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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