Provider Demographics
NPI:1437276821
Name:GENERAL HOSPITAL
Entity Type:Organization
Organization Name:GENERAL HOSPITAL
Other - Org Name:IRAAN GENERAL HOSPITAL DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LEILA
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-639-2575
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:IRAAN
Mailing Address - State:TX
Mailing Address - Zip Code:79744-0665
Mailing Address - Country:US
Mailing Address - Phone:432-639-2575
Mailing Address - Fax:432-639-6292
Practice Address - Street 1:600 HWY 349 NORTH
Practice Address - Street 2:
Practice Address - City:IRAAN
Practice Address - State:TX
Practice Address - Zip Code:79744-0665
Practice Address - Country:US
Practice Address - Phone:432-639-2575
Practice Address - Fax:432-639-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105375100OtherFIRST CARE PROVIDER #
TX00BW33OtherBLUE CROSS PROVIDER #
TX112728401Medicaid
TX00BW33OtherBLUE CROSS PROVIDER #