Healthcare Provider Details

I. General information

NPI: 1013968726
Provider Name (Legal Business Name): HEALTHBRIDGE CHILDREN'S HOSPITAL - HOUSTON, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 WOODLAND PARK DR
HOUSTON TX
77082-2687
US

IV. Provider business mailing address

1 RIVERWAY STE 700
HOUSTON TX
77056-1988
US

V. Phone/Fax

Practice location:
  • Phone: 281-293-7774
  • Fax: 281-293-8117
Mailing address:
  • Phone: 713-355-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number7125
License Number StateTX

VIII. Authorized Official

Name: MS. ERIN L CASSIDY
Title or Position: PRESIDENT
Credential:
Phone: 713-355-6111