1962438028 NPI number — MEMORIAL HERMANN HEALTH SYSTEM

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 1962438028 NPI number — MEMORIAL HERMANN HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL HERMANN HEALTH SYSTEM
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:
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:
1962438028
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 301162
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75303-1162
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-338-4127
Provider Business Mailing Address Fax Number:
713-338-4158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23920 KATY FWY STE 460
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77494-0882
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-338-7300
Provider Business Practice Location Address Fax Number:
713-338-7303
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANDREWS
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR PATIENT BUSINESS SERVICES
Authorized Official Telephone Number:
713-338-7413

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  007859 , 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)





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