1750990388 NPI number — HENDRICK MEDICAL CENTER BROWNWOOD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750990388 NPI number — HENDRICK MEDICAL CENTER BROWNWOOD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENDRICK MEDICAL CENTER BROWNWOOD
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:
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:
1750990388
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1900 PINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ABILENE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79601-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-670-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 BURNETT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNWOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76801-8520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-649-2150
Provider Business Practice Location Address Fax Number:
325-646-5459
Provider Enumeration Date:
07/29/2020

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
JEREMY
Authorized Official Middle Name:
TYLER
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
325-670-2182

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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