1922092790 NPI number — WINNIE-STOWELL HOSPITAL DISTRICT

Table of content: (NPI 1922092790)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922092790 NPI number — WINNIE-STOWELL HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINNIE-STOWELL 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:
GULF POINTE PLAZA
Provider Other Organization Name Type Code:
3
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:
1922092790
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1780 HUGHES LANDING BLVD STE 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77380-4009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-419-5520
Provider Business Mailing Address Fax Number:
281-419-5527

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1008 ENTERPRISE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKPORT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78382-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-729-5254
Provider Business Practice Location Address Fax Number:
361-729-3820
Provider Enumeration Date:
09/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DOHN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
W
Authorized Official Title or Position:
VP OF ACCOUNTING HMG
Authorized Official Telephone Number:
713-897-8848

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  115451 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 128934 , 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: 001003269 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 151208901 . This is a "MEDICAID CO B" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001030445 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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