Provider Demographics
NPI:1407866064
Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Entity type:Organization
Organization Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT HMFW & EVP THR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-882-2106
Mailing Address - Street 1:500 E BORDER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-7445
Mailing Address - Country:US
Mailing Address - Phone:817-570-8500
Mailing Address - Fax:682-236-4620
Practice Address - Street 1:1301 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2122
Practice Address - Country:US
Practice Address - Phone:817-882-3770
Practice Address - Fax:817-882-3781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRIS METHODIST FORT WORTH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-08
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000000235207RC0000X
TX000235282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCD6895OtherMEDICARE RAILROAD
TX00G08PMedicare Oscar/Certification