Provider Demographics
NPI:1215252317
Name:ST MICHAELS HOSPITAL & HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:ST MICHAELS HOSPITAL & HEALTHCARE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-392-5700
Mailing Address - Street 1:2310 ELDRIDGE PKWY S
Mailing Address - Street 2:STE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5254
Mailing Address - Country:US
Mailing Address - Phone:281-392-5700
Mailing Address - Fax:281-392-5795
Practice Address - Street 1:2310 ELDRIDGE PKWY S
Practice Address - Street 2:STE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5254
Practice Address - Country:US
Practice Address - Phone:281-392-5700
Practice Address - Fax:281-392-5795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100048282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
452104Medicare Oscar/Certification