Provider Demographics
NPI:1063618742
Name:VETERTANS HEALTH CARE ADMINISTRATION HOSPITAL
Entity type:Organization
Organization Name:VETERTANS HEALTH CARE ADMINISTRATION HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:LEDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-743-0597
Mailing Address - Street 1:248 WYATT EARP LOOP
Mailing Address - Street 2:
Mailing Address - City:NOLANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76559-9703
Mailing Address - Country:US
Mailing Address - Phone:254-247-1175
Mailing Address - Fax:
Practice Address - Street 1:248 WYATT EARP LOOP
Practice Address - Street 2:
Practice Address - City:NOLANVILLE
Practice Address - State:TX
Practice Address - Zip Code:76559-9703
Practice Address - Country:US
Practice Address - Phone:254-247-1175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX683252284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital