Provider Demographics
NPI:1801893417
Name:SMITHVILLE HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:SMITHVILLE HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-237-3214
Mailing Address - Street 1:800 E HIGHWAY 71
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78957-1730
Mailing Address - Country:US
Mailing Address - Phone:512-237-3214
Mailing Address - Fax:512-237-5768
Practice Address - Street 1:800 E HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TX
Practice Address - Zip Code:78957-1730
Practice Address - Country:US
Practice Address - Phone:512-237-3214
Practice Address - Fax:512-237-5768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMITHVILLE HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-29
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000385282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094115502Medicaid
TX094115502Medicaid