MEDICARE: VICTORY MEDICAL CENTER SOUTHCROSS LP

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	008206	TX

General Provider Information

NPI Number	:	1801805395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORY MEDICAL CENTER SOUTHCROSS LP

Provider Business Mailing Address
First Line	:	2201 TIMBERLOCH PLACE
Second Line	:	SUITE 200
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380
Country	:	US
Telephone Number	:	281-863-2100
Fax Number	:	281-292-2773

Provider Business Practice Location Address
First Line	:	4243 E SOUTHCROSS BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3727
Country	:	US
Telephone Number	:	210-368-7400
Fax Number	:	210-368-7446

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MRS. BELINDA SIMPSON
Credential	:	MBA, RHIA, CHC, CHPC
Telephone Number	:	281-863-2100

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	10/09/2015

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