Provider Demographics
NPI:1699395970
Name:DIMMIT REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:DIMMIT REGIONAL HOSPITAL
Other - Org Name:WOUND CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-876-2424
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-7016
Mailing Address - Country:US
Mailing Address - Phone:830-876-9458
Mailing Address - Fax:830-876-2411
Practice Address - Street 1:304 S 5TH ST
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-3802
Practice Address - Country:US
Practice Address - Phone:830-876-9458
Practice Address - Fax:830-876-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty