Provider Demographics
NPI:1477930121
Name:REAGAN HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:REAGAN HOSPITAL DISTRICT
Other - Org Name:HICKMAN RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:VOELKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-884-5610
Mailing Address - Street 1:1300 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76932-3202
Mailing Address - Country:US
Mailing Address - Phone:325-884-2561
Mailing Address - Fax:325-884-2891
Practice Address - Street 1:1300 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:TX
Practice Address - Zip Code:76932
Practice Address - Country:US
Practice Address - Phone:325-884-3743
Practice Address - Fax:325-884-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673438Medicare UPIN