Provider Demographics
NPI:1386278406
Name:TEXAS CHILDREN'S HOSPITAL
Entity type:Organization
Organization Name:TEXAS CHILDREN'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-828-3660
Mailing Address - Street 1:1250 MOURSUND ST STE 825
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3417
Mailing Address - Country:US
Mailing Address - Phone:877-727-2503
Mailing Address - Fax:832-825-1007
Practice Address - Street 1:1250 MOURSUND ST STE 825
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3417
Practice Address - Country:US
Practice Address - Phone:877-727-2503
Practice Address - Fax:832-825-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy