Organization
COLORADO FAYETTE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN E GULARTE (CEO)
(979) 725-9531
Entity
Organization
Contact information
Practice address
400 YOUENS DR, WEIMAR, TX 78962-3680
(979) 725-9531
(979) 725-8132
Mailing address
400 YOUENS DR, WEIMAR, TX 78962-3680
(979) 725-9531
(979) 725-8132
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
000005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112700301
—
TX
05
—
112700302
—
TX
05
—
112700303
—
TX
05
—
282NR1301X
—
TX
01
—
HH0466
BCBS PROVIDER NUMBER
TX
01
—
HH9604
BCBS HOME HEALTH
TX
Enumeration date
07/13/2006
Last updated
03/27/2012
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