Provider Demographics
NPI:1518082833
Name:BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BALLINGER MEMORIAL HOSPITAL DISTRICT
Other - Org Name:BALLINGER HOSPITAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRICKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-365-2531
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821-0617
Mailing Address - Country:US
Mailing Address - Phone:325-365-2531
Mailing Address - Fax:325-365-5689
Practice Address - Street 1:608 AVENUE B
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821
Practice Address - Country:US
Practice Address - Phone:325-365-2531
Practice Address - Fax:325-365-5689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR1300X
TX000234282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130089907Medicaid
TX130089907Medicaid
TX130089907Medicaid