Provider Demographics
NPI:1548275126
Name:MAVERICK COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MAVERICK COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-757-4990
Mailing Address - Street 1:3406 BOB ROGERS
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5941
Mailing Address - Country:US
Mailing Address - Phone:830-757-4900
Mailing Address - Fax:830-757-8708
Practice Address - Street 1:3406 BOB ROGERS
Practice Address - Street 2:SUITE 120
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5941
Practice Address - Country:US
Practice Address - Phone:830-757-4900
Practice Address - Fax:830-757-8708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137908303Medicaid