Provider Demographics
NPI:1962564617
Name:BELLVILLE HOSPITAL DISTRICT
Entity type:Organization
Organization Name:BELLVILLE HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-865-3141
Mailing Address - Street 1:44 N CUMMINGS ST
Mailing Address - Street 2:PO BOX 977
Mailing Address - City:BELLVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77418-1347
Mailing Address - Country:US
Mailing Address - Phone:979-865-3141
Mailing Address - Fax:979-865-9161
Practice Address - Street 1:235 W PALM ST
Practice Address - Street 2:SUITE 108
Practice Address - City:BELLVILLE
Practice Address - State:TX
Practice Address - Zip Code:77418-1300
Practice Address - Country:US
Practice Address - Phone:979-865-3141
Practice Address - Fax:979-865-9161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U21UOtherBLUE CROSS BLUE SHIELD
TX085587603Medicaid
TX0855876-01Medicaid
TX085587602Medicaid
TX0855876-01Medicaid