Provider Demographics
NPI:1134108053
Name:DAWSON COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:DAWSON COUNTY HOSPITAL DISTRICT
Other - Org Name:MEDICAL ARTS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-872-5727
Mailing Address - Street 1:2200 N BRYAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAMESA
Mailing Address - State:TX
Mailing Address - Zip Code:79331-2451
Mailing Address - Country:US
Mailing Address - Phone:806-872-2183
Mailing Address - Fax:806-872-0823
Practice Address - Street 1:2200 N BRYAN AVE
Practice Address - Street 2:
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-2451
Practice Address - Country:US
Practice Address - Phone:806-872-2183
Practice Address - Fax:806-872-0823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008257282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131041905Medicaid
TX13141903Medicaid
TX450489Medicare Oscar/Certification
TXTXB103632Medicare Oscar/Certification
TX13141903Medicaid