Provider Demographics
NPI:1467742254
Name:ELECTRA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:ELECTRA HOSPITAL DISTRICT
Other - Org Name:IOWA PARK CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:940-495-3981
Mailing Address - Street 1:PO BOX 1112
Mailing Address - Street 2:
Mailing Address - City:ELECTRA
Mailing Address - State:TX
Mailing Address - Zip Code:76360-1112
Mailing Address - Country:US
Mailing Address - Phone:940-495-3981
Mailing Address - Fax:940-495-4137
Practice Address - Street 1:405 SE ACCESS RD
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367
Practice Address - Country:US
Practice Address - Phone:940-495-3981
Practice Address - Fax:940-495-4137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673425Medicare Oscar/Certification