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General NPI Number Information
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NPI Number | 1689639254
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Entity Type | Organization
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Legal Business Name | RIVERSIDE GENERAL HOSPITAL
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 3204 ENNIS STREET
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City | HOUSTON
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State | TX
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Zip | 77004-3213
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Country | US
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Telephone | 713-526-2441
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Fax | 713-526-8754
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Provider Business Mailing Address
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Address Line | 3204 ENNIS ST
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City | HOUSTON
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State | TX
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Zip | 77004-3213
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Country | US
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Telephone | 713-526-2441
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Fax | 713-526-8754
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EARNEST GIBSON III
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Credential |
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Telephone | 713-526-2441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 000460
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License Number State | TX
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