Organization
JOURDANTON HOSPITAL CORPORATION
Active
Other names
South Texas Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE J HOLTSFORD (AUTHORIZED OFFICIAL)
(615) 465-7466
Entity
Organization
Contact information
Practice address
1905 HIGHWAY 97 E, JOURDANTON, TX 78026-1504
(830) 769-3515
(830) 769-5264
Mailing address
PO BOX 847974, DALLAS, TX 75284-7974
(830) 769-3515
(830) 769-5264
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
000334
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121780402
—
TX
01
—
121780403
CHILDRENS SPECIAL NEEDS
—
05
—
121780403
—
TX
01
—
178476300
DEPT OF LABOR
—
01
—
450165
AETNA
—
01
—
620010
FIRST HEALTH
—
01
—
HH0154
BCBS
—
Enumeration date
01/31/2006
Last updated
01/30/2017
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