1619336708 NPI number — MEMORIAL HERMANN MEDICAL GROUP URGENT CARE

Table of content: (NPI 1619336708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619336708 NPI number — MEMORIAL HERMANN MEDICAL GROUP URGENT CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL HERMANN MEDICAL GROUP URGENT CARE
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:
1619336708
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
909 FROSTWOOD DR
Provider Second Line Business Mailing Address:
SUITE 1.100
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-2301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-338-4523
Provider Business Mailing Address Fax Number:
713-338-5500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
909 FROSTWOOD DR
Provider Second Line Business Practice Location Address:
SUITE 1.100
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-338-4523
Provider Business Practice Location Address Fax Number:
713-338-5500
Provider Enumeration Date:
02/17/2016

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
713-338-4523

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com