MEDICARE: RENAISSANCE HOSPITAL TERRELL INC

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	282N00000X	General Acute Care Hospital	008486	TX

General Provider Information

NPI Number	:	1508868639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAISSANCE HOSPITAL TERRELL INC

Provider Business Mailing Address
First Line	:	14440 JOHN F KENNEDY BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77032-5300
Country	:	US
Telephone Number	:	832-886-1900
Fax Number	:	281-227-1139

Provider Business Practice Location Address
First Line	:	1551 HIGHWAY 34 S
Second Line	:
City	:	TERRELL
State	:	TX
Zip	:	75160-4833
Country	:	US
Telephone Number	:	972-551-6820
Fax Number	:	972-551-6901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL R SMESNY
Credential	:
Telephone Number	:	832-886-1900

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/01/2008

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