Provider Demographics
NPI:1164774253
Name:DIMMIT REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:DIMMIT REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:830-876-2424
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-7016
Mailing Address - Country:US
Mailing Address - Phone:830-876-2424
Mailing Address - Fax:830-876-9126
Practice Address - Street 1:704 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-3836
Practice Address - Country:US
Practice Address - Phone:830-876-2424
Practice Address - Fax:830-876-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100064207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty