Provider Demographics
NPI:1538179288
Name:PARKER COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:PARKER COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BACUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-341-2520
Mailing Address - Street 1:1115 PECAN DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5775
Mailing Address - Country:US
Mailing Address - Phone:817-599-1196
Mailing Address - Fax:
Practice Address - Street 1:725 STATE ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5777
Practice Address - Country:US
Practice Address - Phone:817-599-1197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185244401Medicaid
TX132813002Medicaid