Provider Demographics
NPI:1043239577
Name:GUADALUPE COUNTY HOSPITAL BOARD
Entity Type:Organization
Organization Name:GUADALUPE COUNTY HOSPITAL BOARD
Other - Org Name:GUADALUPE REGIONAL MEDICAL CENTER TEDDY BUERGER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNT REP
Authorized Official - Prefix:
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-401-7271
Mailing Address - Street 1:1215 EAST COURT STREET
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155
Mailing Address - Country:US
Mailing Address - Phone:830-379-2411
Mailing Address - Fax:
Practice Address - Street 1:1215 EAST COURT STREET
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155
Practice Address - Country:US
Practice Address - Phone:830-379-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUADALUPE COUNTY HOSPITAL BOARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-18
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00QW35Medicare PIN