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General NPI Number Information
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NPI Number | 1548387418
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Entity Type | Organization
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Legal Business Name | THE METHODIST HOSPITAL
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 6565 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2703
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Country | US
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Telephone | 713-790-3311
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4755
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City | HOUSTON
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State | TX
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Zip | 77210-4755
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Country | US
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Telephone | 832-522-7574
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MARC BOOM
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Credential | MD
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Telephone | 713-441-2671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0124
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 00124
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 000124
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 00124
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 00124
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 00124
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License Number State | TX
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