Provider Demographics
NPI:1205114196
Name:MATAGORDA REGIONAL COUNTY DISTRICT
Entity type:Organization
Organization Name:MATAGORDA REGIONAL COUNTY DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:MS
Authorized Official - First Name:EVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-209-2194
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-0067
Mailing Address - Country:US
Mailing Address - Phone:832-209-2194
Mailing Address - Fax:713-456-2436
Practice Address - Street 1:1115 AVENUE F
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3013
Practice Address - Country:US
Practice Address - Phone:832-209-2194
Practice Address - Fax:713-456-2436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty