| Organization Name: | CONVERSE MEDICAL CENTER |
| NPI Number: | 1104203363 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM FIELDING (CFO) |
| Mailing Address: | 7898 Kitty Hawk Rd Converse |
| State: | TX US |
| Postal Code: | 781090000 |
| Phone Number: | 2104621210 |
| Fax Number: | 2104621214 |
| NPI Enumeration Date: | 04/27/2015 |
| NPI Last Update Date: | 05/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0002X |
| License Number: | 160164 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Emergency Care |
| Taxonomy Definition: | |