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General NPI Number Information
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NPI Number | 1760503106
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Entity Type | Organization
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Legal Business Name | FANNIN COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 315 W ANDERSON ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-5349
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Country | US
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Telephone | 817-599-4181
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 W SAM HOUSTON PKWY N SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77041-5161
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Country | US
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Telephone | 832-467-6000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JUDY ESPITIA
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Credential |
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Telephone | 432-758-4945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 117601
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 117601
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 676148
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License Number State | TX
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