CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY NPI 1780298547

NPI Information

NPI: 1780298547
Provider Name: CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

Doing Business As: CORYELL HEALTH MEDICAL CLINIC MOODY

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 45D2199847

Address:
404 AVENUE E
MOODY, TX
ZIP 76557
Phone: (254) 865-2166
Get Directions

CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY is a rural health clinic center in Moody, TX. CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY NPI is 1780298547. The provider is registered as an organization entity type.
The provider Is Doing Business As Coryell Health Medical Clinic Moody.

The provider's business location address is:

404 AVENUE E
MOODY, TX
ZIP 76557-579
Phone: (254) 865-2166
Fax: (254) 248-0626

The provider's authorized official is Kara Michelle Cox .
The authorized official title is Business Office Manager and has the following contact phone number (254) 248-3213.

The CLIA number assigned to this NPI record is 45D2199847 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2020 and was last updated on 2/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	TEXAS	TIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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