Provider Demographics
NPI:1679004840
Name:TITUS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:TITUS COUNTY HOSPITAL DISTRICT
Other - Org Name:HEART & VASCULAR CENTER AT TITUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:903-577-6066
Mailing Address - Street 1:2015 MULBERRY AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2312
Mailing Address - Country:US
Mailing Address - Phone:903-577-7077
Mailing Address - Fax:
Practice Address - Street 1:2015 MULBERRY AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2312
Practice Address - Country:US
Practice Address - Phone:903-577-7077
Practice Address - Fax:903-577-7072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB151750Medicare PIN