Organization
COMANCHE COUNTY MEDICAL CENTER COMPANY
Active
Other names
Comanche County Medical Center Emergency Room Group
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN STOREY (CEO)
(254) 879-4900
Entity
Organization
Contact information
Practice address
10201 HIGHWAY 16, COMANCHE, TX 76442-4462
(254) 879-4900
(254) 879-4990
Mailing address
10201 HIGHWAY 16, COMANCHE, TX 76442-4462
(254) 879-4900
(254) 879-4990
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
412048192
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00291V
ER PHYS GROUP
TX
01
—
00L94G
BCBS OF TX-ER PHYS GROUP
TX
05
—
121784605
—
TX
Enumeration date
01/27/2006
Last updated
04/25/2012
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