1912769308 NPI number — CHILDRESS COUNTY HOSPITAL DISTRICT

Table of content: DR. ANTHONY EDWIN HATCH DDS (NPI 1669683058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912769308 NPI number — CHILDRESS COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDRESS 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:
Provider Other Organization Name Type Code:
6
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:
1912769308
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4150 INTERNATIONAL PLAZA
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76109-4875
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-348-8959
Provider Business Mailing Address Fax Number:
817-348-0466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1506 CHILDRESS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79095-4108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-447-2513
Provider Business Practice Location Address Fax Number:
682-258-0799
Provider Enumeration Date:
01/30/2024

Additional Information

Authorized Official

Authorized Official Last Name:
HOLOCOMB
Authorized Official First Name:
HOLLY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
940-937-6371

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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