Provider Demographics
NPI:1215157219
Name:PALO PINTO COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:PALO PINTO COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-325-7891
Mailing Address - Street 1:13965 S FM 4
Mailing Address - Street 2:
Mailing Address - City:SANTO
Mailing Address - State:TX
Mailing Address - Zip Code:76472-0000
Mailing Address - Country:US
Mailing Address - Phone:940-769-2018
Mailing Address - Fax:940-328-6523
Practice Address - Street 1:13965 S FM 4
Practice Address - Street 2:
Practice Address - City:SANTO
Practice Address - State:TX
Practice Address - Zip Code:76472-0000
Practice Address - Country:US
Practice Address - Phone:940-769-2018
Practice Address - Fax:940-328-6523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458826Medicare Oscar/Certification