NPIMap

Organization Active NPI

Jackson County Hospital District

Doing business as Jackson Medical Clinic of Ganado

  • Rural Health Clinic/Center
  • Ganado, TX
National Provider Identifier
1346283033
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JACKSON COUNTY HOSPITAL DISTRICT
Doing business as
Jackson Medical Clinic of Ganado
Practice address
202 S Third Street
Ganado, TX 77962-1214
Phone
(361) 771-3571
Fax
(361) 771-3574
NPI assigned
Jun 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Marcella Vana Henke
Title
Administrator/Ceo
Phone
(361) 782-5241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

202 S Third Street
Ganado, TX 77962-1214

Mailing address

1013 South Wells Street
Edna, TX 77957-4098
Phone (361) 782-5241

Other names 1

  • Jackson Medical Clinic of Ganado Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Faisal a Pirzada MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346283033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 SOUTH WELLS STREET",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779574098",
            "telephone_number": "361-782-5241",
            "fax_number": "361-782-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S THIRD STREET",
            "city": "GANADO",
            "state": "TX",
            "postal_code": "779621214",
            "telephone_number": "361-771-3571",
            "fax_number": "361-771-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENKE",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_middle_name": "VANA",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "361-782-5241",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Medical Clinic of Ganado",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ganado, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.