MEDICARE: MEMORIAL HERMANN HEALTH SYSTEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1114704467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HERMANN HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	21501 PARK ROW DR STE 200
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2425
Country	:	US
Telephone Number	:	281-698-6100
Fax Number	:	713-704-3841

Provider Business Practice Location Address
First Line	:	7777 SOUTHWEST FWY STE 104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1805
Country	:	US
Telephone Number	:	281-698-6100
Fax Number	:

Authorized Official
Title or Position	:	AVP GOVERNMENT REPORTING
Name	:	MR. STEVEN WALKER HAND
Credential	:
Telephone Number	:	713-338-4191

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	09/11/2023

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Directions to “MEMORIAL HERMANN HEALTH SYSTEM ” Practice Location

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