MEDICARE: SUGAR LAND 24 HOUR HOSPITAL, LLC

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	282N00000X	General Acute Care Hospital	100018	TX

General Provider Information

NPI Number	:	1851524755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUGAR LAND 24 HOUR HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	10077 GROGANS MILL RD
Second Line	:	PARKWOOD ONE SUITE 100
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1000
Country	:	US
Telephone Number	:	281-292-0769
Fax Number	:

Provider Business Practice Location Address
First Line	:	24727 TOMBALL PKWY
Second Line	:	SUITE 120
City	:	TOMBALL
State	:	TX
Zip	:	77375-7877
Country	:	US
Telephone Number	:	281-516-0911
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HOMER DAVID KIRBY JR.
Credential	:	MD
Telephone Number	:	281-292-0769

Provider Enumeration Date	:	08/26/2009
Last Update Date	:	01/07/2011

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