Provider Demographics
NPI:1790702371
Name:COUNTY OF YOAKUM
Entity type:Organization
Organization Name:COUNTY OF YOAKUM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-592-2121
Mailing Address - Street 1:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:DENVER CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79323-1130
Mailing Address - Country:US
Mailing Address - Phone:806-591-2121
Mailing Address - Fax:806-592-2891
Practice Address - Street 1:412 MUSTANG AVENUE
Practice Address - Street 2:
Practice Address - City:DENVER CITY
Practice Address - State:TX
Practice Address - Zip Code:79323-2750
Practice Address - Country:US
Practice Address - Phone:806-592-2121
Practice Address - Fax:806-592-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QC0050X, 282N00000X, 282NR1301X, 282NW0100X, 284300000X
TX485261QA1903X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No282NR1301XHospitalsGeneral Acute Care HospitalRural
No282NW0100XHospitalsGeneral Acute Care HospitalWomen
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016608OtherSNF UNIT-TITLE XIX MEDICAID CO-INS AGREEMENT
TX451308A000000OtherMEDICARE SECTION 1011
TX137227812Medicaid
TX116054OtherSUPERIOR
TX107077100OtherFIRSTCARE
TXHH0448OtherBCBS OF TX
TX137150100OtherFIRSTCARE ER GROUP
TX137227802OtherMEDICAID ER GROUP
TX137227805OtherMEDICAID ASC
TX137227806Medicaid
TX107077100OtherFIRSTCARE