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General NPI Number Information
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NPI Number | 1134490071
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Entity Type | Organization
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Legal Business Name | KINGWOOD MEDICAL CENTER
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 10/25/2013
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Provider Practice Location Address
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Address Line | 2158 NORTHPARK DR
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City | KINGWOOD
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State | TX
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Zip | 77339-1745
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Country | US
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Telephone | 281-359-9020
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Fax | 972-899-5954
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Provider Business Mailing Address
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Address Line | PO BOX 840795
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City | DALLAS
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State | TX
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Zip | 75284-0795
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Country | US
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Telephone | 972-899-6666
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Fax | 972-899-5954
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Authorized Official
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Title or Position | CFO
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Name | TIM FIELDING
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Credential |
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Telephone | 972-899-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 160032
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License Number State | TX
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