Provider Demographics
NPI:1255325817
Name:MIDLAND COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MIDLAND COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-221-1584
Mailing Address - Street 1:400 ROSALIND REDFERN GROVER PKWY OFC
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6499
Mailing Address - Country:US
Mailing Address - Phone:432-221-3069
Mailing Address - Fax:432-685-1190
Practice Address - Street 1:400 ROSALIND REDFERN GROVER PKWY OFC
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6499
Practice Address - Country:US
Practice Address - Phone:432-221-3069
Practice Address - Fax:432-685-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000452282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136143805Medicaid
TX000452OtherTEXAS DEPT OF HEALTH
TX136143806Medicaid
TX136143813Medicaid
TXHH0491OtherBLUE CROSS PROVIDER NUMBE
AZ067901Medicaid
TX136143804Medicaid
TX104762100OtherFIRST CARE HMO
LA1739774Medicaid
TX136143805Medicaid