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NPI Code Detail

MEDICARE: ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE

MEDICARE: ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283Q00000XPsychiatric Hospital26142TX

General Provider Information

NPI Number : 1407089386
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE
Provider Business Mailing Address
First Line : 1612 S HENDERSON BLVD
Second Line :
City : KILGORE
State : TX
Zip : 75662-3518
Country : US
Telephone Number : 903-984-3505
Fax Number :
Provider Business Practice Location Address
First Line : 1612 S HENDERSON BLVD
Second Line :
City : KILGORE
State : TX
Zip : 75662-3518
Country : US
Telephone Number : 903-984-3505
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : DR. HAMEED A AKILO
Credential : PHARMD
Telephone Number : 903-983-4309
Provider Enumeration Date : 08/26/2009
Last Update Date : 08/26/2009

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Directions to “ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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