Provider Demographics
NPI:1184652372
Name:FRIO HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:FRIO HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-334-2058
Mailing Address - Street 1:105 E HACKBERRY ST
Mailing Address - Street 2:
Mailing Address - City:PEARSALL
Mailing Address - State:TX
Mailing Address - Zip Code:78061-4412
Mailing Address - Country:US
Mailing Address - Phone:830-334-2058
Mailing Address - Fax:830-334-5806
Practice Address - Street 1:105 E HACKBERRY ST STE B
Practice Address - Street 2:
Practice Address - City:PEARSALL
Practice Address - State:TX
Practice Address - Zip Code:78061-4411
Practice Address - Country:US
Practice Address - Phone:830-334-2058
Practice Address - Fax:830-334-5806
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIO HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002021251E00000X
TX0020201251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095113901Medicaid
TX677014Medicare PIN
TX095113901Medicaid