Provider Demographics
NPI:1629089966
Name:METROPLEX ADVENTIST HOSPITAL INC
Entity Type:Organization
Organization Name:METROPLEX ADVENTIST HOSPITAL INC
Other - Org Name:ADVENTHEALTH CENTRAL TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-519-8165
Mailing Address - Street 1:PO BOX 6429
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0429
Mailing Address - Country:US
Mailing Address - Phone:254-519-8165
Mailing Address - Fax:254-526-3483
Practice Address - Street 1:2201 S CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4110
Practice Address - Country:US
Practice Address - Phone:254-519-8165
Practice Address - Fax:254-526-3483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00397261QA1903X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0941197-02Medicaid
TX094484501OtherHASC - MEDICAID
TX450152OtherWORKERS COMP
TX0941197-04OtherMEDICAID-CSHCN ACUTE
TX0944845-03OtherMEDCAID-CSHCN HASC
TX176714400OtherWORKERS COMP
TX6541720OtherAETNA
TX950570OtherAETNA
TX450152OtherSTATE AGENCY
TXHH0574OtherBLUE CROSS BLUE SHIELD
TX20489OtherSCOTT & WHITE HEALTH
TXMETROPDOtherSCOTT & WHITE HEALTH
TX0941197-06OtherCSHCN HASC
TX104862100OtherFIRST HEALTH
TXHH0574OtherANTHEM LIFE INSURANCE COM
TX0941197-05OtherHASC OP
TX104862100OtherFIRSTCARE
TX450152OtherUNICARE
TXH04501526OtherSTATE AGENCY
TX450152Medicare Oscar/Certification
TX=========OtherPHCS/PRIVATE HLTHCRE SYS