Provider Demographics
NPI:1285789917
Name:MEMORIAL HERMANN HEALTH SYSTEM
Entity type:Organization
Organization Name:MEMORIAL HERMANN HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-242-2396
Mailing Address - Street 1:PO BOX 301162
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75303-1162
Mailing Address - Country:US
Mailing Address - Phone:713-338-7400
Mailing Address - Fax:713-338-7401
Practice Address - Street 1:902 FROSTWOOD DR STE 288
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2403
Practice Address - Country:US
Practice Address - Phone:713-338-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002338251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451562Medicare Oscar/Certification