# CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COMMUNITY CARE CENTER OF CROCKETT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477093284
- **Authorized official:** MR. DAVID K BYROM (CEO)
- **Authorized official phone:** (254) 248-6300

## Contact information

- **Practice address:** 1150 E LOOP 304, CROCKETT, TX 75835-1810
- **Practice address phone:** (936) 544-2051
- **Practice address fax:** (936) 544-8961
- **Mailing address:** 1150 E LOOP 304, CROCKETT, TX 75835-1810
- **Mailing address phone:** (936) 544-2051
- **Mailing address fax:** (936) 544-8961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2017
- **Last updated:** 02/27/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004802 | — | TX |