Provider Demographics
NPI:1982671491
Name:BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION
Other - Org Name:BAPTIST ST. ANTHONY'S HEALTH SYSTEM-BAPTIST CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:806-212-5170
Mailing Address - Street 1:1600 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1799
Mailing Address - Country:US
Mailing Address - Phone:806-212-2000
Mailing Address - Fax:
Practice Address - Street 1:1600 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1799
Practice Address - Country:US
Practice Address - Phone:806-212-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST ST ANTHONY'S HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-02
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000001261QA1903X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133457505Medicaid
TX758417260OtherAETNA
TX133457503Medicaid
TX133457504Medicaid
TXHH0626OtherBLUE CROSS
TX133457506Medicaid
TX133457505Medicaid
TX133457504Medicaid