Provider Demographics
NPI:1528015815
Name:DAWSON COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:DAWSON COUNTY HOSPITAL DISTRICT
Other - Org Name:MEDICAL ARTS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-872-5727
Mailing Address - Street 1:2202 N BRYAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAMESA
Mailing Address - State:TX
Mailing Address - Zip Code:79331-2451
Mailing Address - Country:US
Mailing Address - Phone:806-872-7494
Mailing Address - Fax:806-872-5917
Practice Address - Street 1:2202 N BRYAN AVE
Practice Address - Street 2:
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-2451
Practice Address - Country:US
Practice Address - Phone:806-872-7494
Practice Address - Fax:806-872-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453466Medicare UPIN