Provider Demographics
NPI:1124517347
Name:MH EMERUS TOMBALL LLC
Entity type:Organization
Organization Name:MH EMERUS TOMBALL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-637-1004
Mailing Address - Street 1:8686 NEW TRAILS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1176
Mailing Address - Country:US
Mailing Address - Phone:713-637-1146
Mailing Address - Fax:713-637-1084
Practice Address - Street 1:16000 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2674
Practice Address - Country:US
Practice Address - Phone:281-277-0911
Practice Address - Fax:281-277-4511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX379968601Medicaid
TX67-0095OtherMEDICARE