Provider Demographics
NPI:1306989322
Name:TITUS COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:TITUS COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:EAN
Authorized Official - Last Name:BOECKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-577-6059
Mailing Address - Street 1:2001 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2338
Mailing Address - Country:US
Mailing Address - Phone:903-577-6000
Mailing Address - Fax:903-434-8076
Practice Address - Street 1:2320 HARTS BLUFF RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-7453
Practice Address - Country:US
Practice Address - Phone:903-577-9355
Practice Address - Fax:903-434-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000137261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L46VOtherBLUE CROSS BLUE SHIELD
TX063357001Medicaid
TX00L46VOtherBLUE CROSS BLUE SHIELD