MEDICARE: EL CAMPO MEMORIAL HOSPITAL

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1699230185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL CAMPO MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	305 SANDY CORNER RD
Second Line	:
City	:	EL CAMPO
State	:	TX
Zip	:	77437-9535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W NORRIS ST
Second Line	:
City	:	EL CAMPO
State	:	TX
Zip	:	77437-2430
Country	:	US
Telephone Number	:	979-543-5510
Fax Number	:

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	ANITA M CRISP
Credential	:
Telephone Number	:	979-543-5510

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	02/08/2019

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Directions to “EL CAMPO MEMORIAL HOSPITAL ” Practice Location

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