Healthcare Provider Details

I. General information

NPI: 1700955796
Provider Name (Legal Business Name): THC - HOUSTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E SAM HOUSTON PKWY S
PASADENA TX
77505
US

IV. Provider business mailing address

4801 E SAM HOUSTON PKWY S
PASADENA TX
77505-3955
US

V. Phone/Fax

Practice location:
  • Phone: 281-991-5463
  • Fax: 281-991-1655
Mailing address:
  • Phone: 281-991-5463
  • Fax: 281-991-1655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number000801
License Number StateTX

VIII. Authorized Official

Name: MR. TERRANCE K. DILLON
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 502-596-7220