Organization
SCOTT & WHITE HOSPITAL - MARBLE FALLS
Active
Other names
BAYLOR SCOTT & WHITE CLINIC - LLANO
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY OLS (CEO)
(830) 201-8679
Entity
Organization
Contact information
Practice address
102 E YOUNG ST, LLANO, TX 78643-1349
(325) 247-4131
(325) 247-2562
Mailing address
PO BOX 844658, DALLAS, TX 75284-4339
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
100090
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0042WF
BCBS
TX
01
—
282267802
MEDICAID THSTEPS
TX
05
—
282267803
—
TX
Enumeration date
11/12/2010
Last updated
10/17/2019
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