1437218062 NPI number — MONTGOMERY COUNTY HOSPITAL DISTRICT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437218062 NPI number — MONTGOMERY COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONTGOMERY COUNTY HOSPITAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437218062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2587
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONROE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77305-2587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-523-1128
Provider Business Mailing Address Fax Number:
936-539-2766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 SOUTH LOOP 336 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77304-3504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-523-1128
Provider Business Practice Location Address Fax Number:
936-539-2766
Provider Enumeration Date:
12/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
RITA
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
936-523-1128

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  300189 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47240 . This is a "HMO BLUE STAR PLUS 81053" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: XMTE06119 . This is a "CAID SAN MATEO CA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 0070831 . This is a "BC BS OF TN 180150" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 296743 . This is a "BC BS OF PA 898845" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 300189 . This is a "ESIS 419310" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 41527 . This is a "CHIPS AMERIKIDS 62947" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 107752101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590006512 . This is a "RR MCARE 10066" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: AMB300189 . This is a "TEXAS MUTUAL 841843" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 300128 . This is a "TEXAS MUTUAL 12029" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1014892 . This is a "AETNA 1125" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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