Provider Demographics
NPI:1437287091
Name:STARR COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:STARR COUNTY MEMORIAL HOSPITAL
Other - Org Name:AMBULATORY SURGICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THALIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:956-487-5561
Mailing Address - Street 1:128 N FM 3167
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6211
Mailing Address - Country:US
Mailing Address - Phone:956-487-5561
Mailing Address - Fax:956-487-0131
Practice Address - Street 1:128 N. FM 3167
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6211
Practice Address - Country:US
Practice Address - Phone:956-487-5561
Practice Address - Fax:956-487-4680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X, 282NR1301X
TX000393282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136332704Medicaid
TX136332704Medicaid