Fannin County Hospital Authority
Organization Active NPI Family Medicine Physician · Bonham, TX
NPI 1184047599 · NPPES record last updated Jan 22, 2014
Key facts
- NPI
- 1184047599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FANNIN COUNTY HOSPITAL AUTHORITY
- Practice address
- 2105 N Center St
Bonham, TX 75418-2627 - Phone
- (903) 449-4698
- NPI assigned
- Jan 22, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- FANNIN COUNTY HOSPITAL AUTHORITY
Authorized official
- Name
- Jay J Hodges
- Title
- Cfo
- Phone
- (903) 640-7311
Other NPIs on the same Medicare enrollment 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130923000100 | TX | Part B Supplier - Clinic/Group Practice | 6002054764 |
Receives reassigned benefits from 4 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bonham, TX; Van Alstyne, TX |
National Provider Directory
- Part of
- Fannin Cnty Hosp Authority
Locations
2105 N Center St
Bonham, TX 75418
Phone (903) 449-4698
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
2105 N Center St
Bonham, TX 75418-2627
Mailing address
PO Box C
Bonham, TX 75418-0180
Phone (903) 640-7311
Other names
- Red River Family Practice
Other providers in Bonham, TX
- Christine Ryon Eger
- John E Egstad
- Charles Ray Ellexson
- Fairview Nursing and Rehabilitation LP
- Family First Homecare, LLC
- Fannin County Hospital Authority
- Fannin County Hospital Authority
- Fannin County Hospital Authority
- Fannin County Hospital Authority
- Fannin County Hospital Authority
All providers in Bonham, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.