Organization
JOURDANTON HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE T BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
1905 HIGHWAY 97 E, JOURDANTON, TX 78026-1504
(830) 769-3515
(830) 769-5264
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(888) 801-5554
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
TX
207Q00000X
Family Medicine Physician
—
TX
208100000X
Physical Medicine & Rehabilitation Physician
—
—
363A00000X
Physician Assistant
PA01235
PA
364SF0001X
Family Health Clinical Nurse Specialist
—
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202530601
—
TX
01
—
202530602
MEDICAID-TEXAS HEALTH STEPS
TX
Enumeration date
05/30/2008
Last updated
06/21/2018
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