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Organization

CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

Active
Parent organization
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Other names
Coryell Health Medical Clinic Moody
Organization subpart
Yes

Provider details

NPI number
Legal business name
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Authorized official
KARA MICHELLE COX (BUSINESS OFFICE MANAGER)
(254) 248-3213
Entity
Organization

Contact information

Practice address
404 AVENUE E, MOODY, TX 76557-3579
(254) 865-2166
(254) 248-0626
Mailing address
1507 W MAIN ST, GATESVILLE, TX 76528-1024
(254) 865-2166
(254) 248-0626

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
=========
TIN
TX
Enumeration date
08/31/2020
Last updated
02/05/2021
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