Provider Demographics
NPI:1558574699
Name:HONDO HOSPTIAL AUTHORITY
Entity Type:Organization
Organization Name:HONDO HOSPTIAL AUTHORITY
Other - Org Name:MEDICAL CLINIC OF DEVINE THSTEPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAID BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-426-7891
Mailing Address - Street 1:3100 AVE E
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861
Mailing Address - Country:US
Mailing Address - Phone:830-665-2876
Mailing Address - Fax:
Practice Address - Street 1:300 N TEEL
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016
Practice Address - Country:US
Practice Address - Phone:830-665-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty