MEDICARE: UVALDE COUNTY HOSPITAL AUTHORITY

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	261QR1300X	Rural Health Clinic/Center		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	88230G	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1821096140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UVALDE COUNTY HOSPITAL AUTHORITY

Provider Business Mailing Address
First Line	:	1025 GARNER FLD RD
Second Line	:
City	:	UVALDE
State	:	TX
Zip	:	78801-4809
Country	:	US
Telephone Number	:	830-278-6251
Fax Number	:	830-278-3756

Provider Business Practice Location Address
First Line	:	517 N. CENTER ST
Second Line	:
City	:	SABINAL
State	:	TX
Zip	:	78881-0509
Country	:	US
Telephone Number	:	830-988-2985
Fax Number	:	830-988-2410

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JAMES E BUCKNER JR.
Credential	:
Telephone Number	:	830-278-6251

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/21/2022

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Directions to “UVALDE COUNTY HOSPITAL AUTHORITY ” Practice Location

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