Provider Demographics
NPI:1699080135
Name:METHODIST HOSPITAL PLAINVIEW TEXAS
Entity type:Organization
Organization Name:METHODIST HOSPITAL PLAINVIEW TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-293-5113
Mailing Address - Street 1:2222 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-1802
Mailing Address - Country:US
Mailing Address - Phone:806-293-5113
Mailing Address - Fax:806-291-0069
Practice Address - Street 1:1224 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MATADOR
Practice Address - State:TX
Practice Address - Zip Code:79244
Practice Address - Country:US
Practice Address - Phone:806-347-2641
Practice Address - Fax:806-347-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-8898OtherCMS CERTIFICATION NUMBER