Provider Demographics
NPI:1639511207
Name:SCOTT & WHITE HOSPITAL - MARBLE FALLS
Entity Type:Organization
Organization Name:SCOTT & WHITE HOSPITAL - MARBLE FALLS
Other - Org Name:BAYLOR SCOTT & WHITE CLINIC - JOHNSON CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-201-8679
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:208 HALEY RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TX
Practice Address - Zip Code:78636
Practice Address - Country:US
Practice Address - Phone:325-247-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health