1598096802 NPI number — MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC

Table of content: (NPI 1598096802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598096802 NPI number — MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC
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:
1598096802
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1120 BUSINESS CENTER DR
Provider Second Line Business Mailing Address:
STE 110
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77043-2735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-337-1111
Provider Business Mailing Address Fax Number:
713-337-1112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1120 BUSINESS CENTER DR
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77043-2735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-337-1111
Provider Business Practice Location Address Fax Number:
713-337-1112
Provider Enumeration Date:
01/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CRAFTS
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER/AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
832-729-4009

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  130143 , 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)





Copyright © 2007-2025 www.npivalidator.com