Provider Demographics
NPI:1730428152
Name:SAN AUGUSTINE CITY COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:SAN AUGUSTINE CITY COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-275-6001
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:SAN AUGUSTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75972-0114
Mailing Address - Country:US
Mailing Address - Phone:936-288-0027
Mailing Address - Fax:
Practice Address - Street 1:208 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SAN AUGUSTINE
Practice Address - State:TX
Practice Address - Zip Code:75972-2320
Practice Address - Country:US
Practice Address - Phone:936-288-0027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPROVISIONAL3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport