Organization
GOOD SHEPHERD MEDICAL CENTER - LINDEN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD BANOS (CEO)
(903) 315-2000
Entity
Organization
Contact information
Practice address
404 N KAUFMAN ST, LINDEN, TX 75563-5234
(903) 756-5561
(903) 756-3718
Mailing address
404 N KAUFMAN ST, LINDEN, TX 75563-5234
(903) 756-5561
(903) 756-3718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
282NC0060X
Critical Access Hospital
Primary
008221
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004NP
BLUE CROSS/PROFESSIONAL PROVIDER #
TX
05
—
183315401
—
TX
01
—
HH0386
BLUE CROSS PROV#
TX
Enumeration date
04/18/2006
Last updated
02/09/2010
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