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General NPI Number Information
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NPI Number | 1538157326
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Entity Type | Organization
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Legal Business Name | INTRACARE HOSPITAL
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 7601 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77054-1905
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Country | US
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Telephone | 713-790-0949
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Fax | 713-799-0365
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Provider Business Mailing Address
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Address Line | 7601 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77054-1905
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Country | US
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Telephone | 713-790-0949
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Fax | 713-799-0365
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Authorized Official
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Title or Position | CEO HEALTHCARE OPERATIONS
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Name | MR. TERRY SCOVILL
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Credential |
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Telephone | 713-799-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 762
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License Number State | TX
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