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Organization
PECOS COUNTY MEMORIAL HOSPITAL
Active
Organization
PECOS COUNTY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA PENA (DIRECTOR)
(432) 336-4880
Entity
Organization
Contact information
Practice address
387 WEST IH 10, FORT STOCKTON, TX 79735-2700
(432) 336-2058
(844) 824-3604
Mailing address
387 WEST IH 10, FORT STOCKTON, TX 79735-2700
(432) 336-2058
(432) 336-4511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0079AE
BCBS GROUP NUMBER
TX
05
—
091939102
—
TX
05
—
091939103
—
TX
Enumeration date
05/25/2006
Last updated
11/08/2019
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