Provider Demographics
NPI:1629166129
Name:DUBUIS HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:DUBUIS HEALTH SYSTEM, INC.
Other - Org Name:DUBUIS HOSPITAL OF TEXARKANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-277-2334
Mailing Address - Street 1:2400 SAINT MICHAEL DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2374
Mailing Address - Country:US
Mailing Address - Phone:903-614-7600
Mailing Address - Fax:903-614-7639
Practice Address - Street 1:2400 SAINT MICHAEL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2374
Practice Address - Country:US
Practice Address - Phone:903-614-7600
Practice Address - Fax:903-614-7639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000822282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193783101Medicaid
TXHH0979OtherBLUE CROSS BLUE SHIELD
AR83855OtherBLUE CROSS BLUE SHIELD
TXHH0979OtherBLUE CROSS BLUE SHIELD