1194893263 NPI number — BAYLOR COUNTY HOSPITAL DISTRICT

Table of content: (NPI 1194893263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194893263 NPI number — BAYLOR COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYLOR COUNTY HOSPITAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SEYMOUR HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194893263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 STADIUM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEYMOUR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76380-2344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-889-5572
Provider Business Mailing Address Fax Number:
940-889-3337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 STADIUM DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEYMOUR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76380-2344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-889-5572
Provider Business Practice Location Address Fax Number:
940-889-3337
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARDIN
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
940-889-5572

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 000546 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC0060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282NR1301X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 138353107 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000629801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138353101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138353106 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0107 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 138353103 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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