Provider Demographics
NPI:1992832604
Name:HARDIN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:HARDIN COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HARDIN COUNTY HEALTH DE
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:PASTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-246-5188
Mailing Address - Street 1:440 WEST MONROE
Mailing Address - Street 2:
Mailing Address - City:KOUNTZE
Mailing Address - State:TX
Mailing Address - Zip Code:77625-5414
Mailing Address - Country:US
Mailing Address - Phone:409-246-5188
Mailing Address - Fax:409-246-4373
Practice Address - Street 1:440 WEST MONROE
Practice Address - Street 2:
Practice Address - City:KOUNTZE
Practice Address - State:TX
Practice Address - Zip Code:77625-5414
Practice Address - Country:US
Practice Address - Phone:409-246-5188
Practice Address - Fax:409-246-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPH0040Medicare PIN