Organization
MEMORIAL HOSPITAL SAN AUGUSTINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FONDA R SULLIVAN (INSURANCE SUPERVISOR)
(936) 631-3474
Entity
Organization
Contact information
Practice address
511 E HOSPITAL ST, SAN AUGUSTINE, TX 75972-2121
(936) 631-3474
(936) 631-3475
Mailing address
511 E HOSPITAL ST, SAN AUGUSTINE, TX 75972-2121
(936) 631-3474
(936) 631-3475
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
F1233
TX
174400000X
Specialist
G5444
TX
174400000X
Specialist
G8896
TX
174400000X
Specialist
Primary
K3986
TX
174400000X
Specialist
L9581
TX
Other
Enumeration date
05/30/2006
Last updated
08/22/2020
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