Healthcare Provider Details

I. General information

NPI: 1487869012
Provider Name (Legal Business Name): MEMORIAL HERMANN SUGAR LAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14857 SOUTHWEST FWY STE 303
SUGAR LAND TX
77478-5016
US

IV. Provider business mailing address

3003 FIVE OAKS DR
MISSOURI CITY TX
77459-6505
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-8900
  • Fax: 281-242-0355
Mailing address:
  • Phone: 281-778-7597
  • Fax: 281-242-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1101525
License Number StateTX

VIII. Authorized Official

Name: MR. MICHAEL CABIRO
Title or Position: DIRECTOR
Credential: PT, OCS, CSCS
Phone: 281-242-8900