Healthcare Provider Details

I. General information

NPI: 1295959294
Provider Name (Legal Business Name): SJ MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 ST JOSEPH PKWY
HOUSTON TX
77002-8301
US

IV. Provider business mailing address

1401 ST JOSEPH PKWY ATTN: BILLING
HOUSTON TX
77002-8301
US

V. Phone/Fax

Practice location:
  • Phone: 713-757-1000
  • Fax:
Mailing address:
  • Phone: 713-757-1000
  • Fax: 713-657-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY S BASSETT
Title or Position: HOSPITAL PRESIDENT
Credential:
Phone: 713-757-1000