Provider Demographics
NPI:1124224621
Name:MEDICAL CLINIC OF HARDIN COUNTY
Entity Type:Organization
Organization Name:MEDICAL CLINIC OF HARDIN COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HORSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:409-782-1489
Mailing Address - Street 1:805 HIGHWAY 69 S
Mailing Address - Street 2:P.O. BOX 1316
Mailing Address - City:KOUNTZE
Mailing Address - State:TX
Mailing Address - Zip Code:77625-6945
Mailing Address - Country:US
Mailing Address - Phone:409-751-5911
Mailing Address - Fax:409-751-0059
Practice Address - Street 1:805 HIGHWAY 69 S
Practice Address - Street 2:
Practice Address - City:KOUNTZE
Practice Address - State:TX
Practice Address - Zip Code:77625-6945
Practice Address - Country:US
Practice Address - Phone:409-751-5911
Practice Address - Fax:409-751-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty