Healthcare Provider Details

I. General information

NPI: 1295843787
Provider Name (Legal Business Name): MEMORIAL HERMANN HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 MEMORIAL NORTH
HUMBLE TX
77338-4217
US

IV. Provider business mailing address

PO BOX 301208
DALLAS TX
75303-1208
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-7700
  • Fax:
Mailing address:
  • Phone: 713-338-4127
  • Fax: 713-338-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS LARAWAY
Title or Position: CFO
Credential:
Phone: 713-242-2707