Provider Demographics
NPI:1568483931
Name:WEST WHARTON COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:WEST WHARTON COUNTY HOSPITAL DISTRICT
Other - Org Name:MID COAST MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELWOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:979-578-5251
Mailing Address - Street 1:305 SANDY CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-9693
Mailing Address - Country:US
Mailing Address - Phone:979-543-5510
Mailing Address - Fax:979-543-4137
Practice Address - Street 1:305 SANDY CORNER RD
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-9693
Practice Address - Country:US
Practice Address - Phone:979-543-5510
Practice Address - Fax:979-543-4137
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST WHARTON COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX063358801Medicaid
TX00U11ZMedicare PIN
TX063358801Medicaid