Healthcare Provider Details

I. General information

NPI: 1508855313
Provider Name (Legal Business Name): METHODIST HOSPITAL LEVELLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 COLLEGE AVE
LEVELLAND TX
79336-6507
US

IV. Provider business mailing address

PO BOX 677044
DALLAS TX
75267-7044
US

V. Phone/Fax

Practice location:
  • Phone: 806-894-3141
  • Fax: 806-894-7094
Mailing address:
  • Phone: 806-894-3141
  • Fax: 806-894-7094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number000307
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number000307
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number000307
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number000307
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number000307
License Number StateTX

VIII. Authorized Official

Name: DONALD W ANDERSON JR.
Title or Position: ASSISTANT SECRETARY OF ENROLLMENTS
Credential:
Phone: 425-358-9786