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NPI 1740469824

NPI 1740469824 : NORTHEAST HOSPITAL AUTHORITY : HUMBLE, TX

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General NPI Number Information
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    NPI Number           |    1740469824
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTHEAST HOSPITAL AUTHORITY 
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Dates
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    Enumeration Date     |    10/25/2007
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    Last Update Date     |    11/01/2007
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Provider Practice Location Address
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    Address Line         |    18951 N MEMORIAL DR 
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    City                 |    HUMBLE
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    State                |    TX
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    Zip                  |    77338-4217
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    Country              |    US
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    Telephone            |    281-540-7852
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    Fax                  |    281-540-7368
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Provider Business Mailing Address
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    Address Line         |    18951 N MEMORIAL DR 
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    City                 |    HUMBLE
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    State                |    TX
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    Zip                  |    77338-4217
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    Country              |    US
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    Telephone            |    281-540-7962
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    Fax                  |    281-540-6375
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Authorized Official
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    Title or Position    |    PRESIDENT, NE HOSPITAL AUTHORITY
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    Name                 |    MR. ROY G. HEARNSBERGER 
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    Credential           |    
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    Telephone            |    281-540-7852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251G00000X
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    Taxonomy Name        |    Community Based Hospice Care Agency
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    License Number       |    
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    License Number State |    
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