Organization Active NPI

Teague Hospital Authority

  • Land Ambulance
  • Teague, TX
National Provider Identifier
1184628752
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
081101 Issued in TX
Legal business name
TEAGUE HOSPITAL AUTHORITY
Practice address
802 US Highway 84 East
Teague, TX 75860-5142
Phone
(254) 739-2536
Fax
(832) 778-5040
NPI assigned
Jun 10, 2005
Last updated
Mar 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Flippin III
Title
EMS Supervisor
Phone
(254) 739-2536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 081101 TX Primary

Addresses

Primary practice location

802 US Highway 84 East
Teague, TX 75860-5142

Mailing address

PO Box 599
Teague, TX 75860-0599
Phone (903) 473-0927

Other identifiers 1

IdentifierTypeStateIssuer
156662201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610001703 TX Part B Supplier - Ambulance Service Supplier 7113900093 Practice locations: Teague, TX

National Provider Directory

National Provider Directory

Locations

802 US Highway 84 W
Teague, TX 75860
Phone (254) 739-2536

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1184628752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 599",
            "city": "TEAGUE",
            "state": "TX",
            "postal_code": "758600599",
            "telephone_number": "903-473-0927",
            "fax_number": "832-778-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 US HIGHWAY 84 EAST",
            "city": "TEAGUE",
            "state": "TX",
            "postal_code": "758605142",
            "telephone_number": "254-739-2536",
            "fax_number": "832-778-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAGUE HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "FLIPPIN III",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "EMS SUPERVISOR",
        "authorized_official_telephone_number": "254-739-2536"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "081101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156662201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teague, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.