Provider Demographics
NPI:1225194822
Name:HILL COUNTRY MEMORIAL HOSPITAL-CHC
Entity Type:Organization
Organization Name:HILL COUNTRY MEMORIAL HOSPITAL-CHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BA, RRT
Authorized Official - Phone:830-992-2554
Mailing Address - Street 1:140 INDUSTRIAL LOOP # 2
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-5456
Mailing Address - Country:US
Mailing Address - Phone:830-992-2593
Mailing Address - Fax:830-990-1400
Practice Address - Street 1:140 INDUSTRIAL LOOP # 2
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-5456
Practice Address - Country:US
Practice Address - Phone:830-992-2593
Practice Address - Fax:830-990-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility