MEDICARE: CHG CORNERSTONE HOSPITAL OF HOUSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282E00000X	Long Term Care Hospital	008282	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104045699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHG CORNERSTONE HOSPITAL OF HOUSTON

Provider Business Mailing Address
First Line	:	2200 ROSS AVE
Second Line	:	SUITE 5400
City	:	DALLAS
State	:	TX
Zip	:	75201-2708
Country	:	US
Telephone Number	:	469-621-6700
Fax Number	:	469-621-6672

Provider Business Practice Location Address
First Line	:	5314 DASHWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-4603
Country	:	US
Telephone Number	:	713-295-5300
Fax Number	:	713-295-5301

Authorized Official
Title or Position	:	CENTRAL BUSINESS OFFICE DIRECTOR
Name	:	MRS. LYNN HUDSON
Credential	:
Telephone Number	:	469-621-6716

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	10/02/2013

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