Provider Demographics
NPI:1770519159
Name:HAMILTON COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:HAMILTON COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-386-1950
Mailing Address - Street 1:1939 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-2805
Mailing Address - Country:US
Mailing Address - Phone:210-434-0671
Mailing Address - Fax:210-432-0506
Practice Address - Street 1:1939 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-2805
Practice Address - Country:US
Practice Address - Phone:210-434-0671
Practice Address - Fax:210-432-0506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113696314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH7000OtherBCBS OF TEXAS
TX000490505Medicaid
TX000490505Medicaid
TX1279760001Medicare NSC
TXHH7000OtherBCBS OF TEXAS