Organization
MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE ANN BRIDGES CPA (CHIEF FINANCIAL OFFICER)
(936) 568-8525
Entity
Organization
Contact information
Practice address
1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
(936) 564-4611
Mailing address
1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
(936) 564-4611
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
000478
TX
207P00000X
Emergency Medicine Physician
Primary
000478
TX
363A00000X
Physician Assistant
000478
TX
367500000X
Certified Registered Nurse Anesthetist
000478
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131030201
—
TX
Enumeration date
07/05/2006
Last updated
08/11/2008
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