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Organization

JACKSON COUNTY HOSPITAL DISTRICT

Active
Other names
Jackson Medical Clinic of Ganado
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARCELLA VANA HENKE (ADMINISTRATOR/CEO)
(361) 782-5241
Entity
Organization

Contact information

Practice address
202 S THIRD STREET, GANADO, TX 77962-1214
(361) 771-3571
(361) 771-3574
Mailing address
1013 S WELLS ST, EDNA, TX 77957-4098
(361) 782-5241
(361) 782-7495

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85637001
TX
Enumeration date
06/29/2006
Last updated
09/11/2025
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