1750341038 NPI number — TOMBALL HOSPITAL AUTHORITY

Table of content: (NPI 1750341038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750341038 NPI number — TOMBALL HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOMBALL HOSPITAL AUTHORITY
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:
1750341038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 889
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOMBALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77377-0889
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-401-7500
Provider Business Mailing Address Fax Number:
281-351-7830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
605 HOLDERRIETH BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOMBALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77375-6445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-401-7500
Provider Business Practice Location Address Fax Number:
281-351-7830
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARBER
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
D
Authorized Official Title or Position:
COO CFO
Authorized Official Telephone Number:
281-401-7633

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  00076 , 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: XHSP42324 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 154683105 , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 900906000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 018709808 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1747289 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200495280A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50000105 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6999905 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: HOS0670N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000107764A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 431420000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 025785 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000A848 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13044305 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06521548 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP32324 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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