Frio Hospital Association
Organization Active NPI Rural Health Clinic/Center · Dilley, TX
NPI 1255977211 · NPPES record last updated Aug 15, 2022
Key facts
- NPI
- 1255977211
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FRIO HOSPITAL ASSOCIATION
- Practice address
- 801 FM W 117
Dilley, TX 78017 - Phone
- (830) 334-2058
- NPI assigned
- Nov 25, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- FRIO HOSPITAL ASSOCIATION
Authorized official
- Name
- Ms. Monica Ann Martinez
- Title
- Rural Health Clinic Director
- Phone
- (830) 334-2058
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Practitioners 13
-
William Richard Vandiver, M.D.
-
Samer Arab, MD
-
John David Barrera, FNP
-
James W Bean, MD
-
Joseph Scott Houghton, CRNA
-
Mary L Moore, PA C
-
Diane Roel, NURSE PRACTITIONER
-
Muhammad B Khan, M.D.
-
Michael Lee Wanamaker, M.D.
-
Sarjoo B Patel, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Rural health clinic certification: CCN 673493
- Legal name
- FRIO HOSPITAL ASSOCIATION
- Doing business as
- READYCARE-DILLEY
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 15, 2020
- Last certification
- Jan 11, 2024
- Ownership / control type
- 2B
- Organization structure
- Other · Non-profit
- Incorporated
- May 19, 1958 in TX
- Enrollment address
- 801 W FM 117
Dilley, TX 78017-3409 - Related CCNs
- 451391
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Ruff |
Corporate Director |
Sep 29, 2021 | |
| W-2 Managing Employee |
Sep 29, 2021 | ||
| John Hughson |
Corporate Officer |
Dec 1, 2020 | |
| Corporate Director |
Dec 1, 2020 | ||
| W-2 Managing Employee |
Dec 1, 2020 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Frio Hospital Home Health Agency |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200608001418 | TX | Part a Provider - Rural Health Clinic | 4981599693 |
Receives reassigned benefits from 1 practitioner Practice locations: Dilley, TX |
National Provider Directory
- Tax ID family
- Frio Hospital
- Part of
- Frio Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
801 FM W 117
Dilley, TX 78017
Mailing address
200 S Interstate 35
Pearsall, TX 78061-6601
Phone (830) 334-2058
Other names
- ReadyCare-Dilley
Other providers in Dilley, TX
- Dilley Ambulance Service, Inc.
- Dilley Drug Store LC
- Dilley Isd
- Dilley Pharmacy, LLC
- James Mashburn Fitts
- Delys V. Gribbin
- Herbert I Garfield
- Hometown Healthcare LLC
- Libra Emergency Physicians, PLLC
- Alicia E Mills
All providers in Dilley, TX · Rural Health Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2022. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.