MEDICARE: POLARIS HEALTH SYSTEM, 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	284300000X	Special Hospital

General Provider Information

NPI Number	:	1518350297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLARIS HEALTH SYSTEM, INC.

Provider Business Mailing Address
First Line	:	3204 ENNIS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-3213
Country	:	US
Telephone Number	:	713-526-2441
Fax Number	:	713-526-3554

Provider Business Practice Location Address
First Line	:	3204 ENNIS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-3213
Country	:	US
Telephone Number	:	713-526-2441
Fax Number	:	713-526-3554

Authorized Official
Title or Position	:	CHIEF HOSPITAL ADMINISTRATOR
Name	:	DR. ANTHONY TRANG
Credential	:	PHD
Telephone Number	:	713-526-2441

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	03/05/2015

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Directions to “POLARIS HEALTH SYSTEM, INC. ” Practice Location

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