Provider Demographics
NPI:1487869012
Name:MEMORIAL HERMANN SUGAR LAND
Entity type:Organization
Organization Name:MEMORIAL HERMANN SUGAR LAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CABIRO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS, CSCS
Authorized Official - Phone:281-242-8900
Mailing Address - Street 1:3003 FIVE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6505
Mailing Address - Country:US
Mailing Address - Phone:281-778-7597
Mailing Address - Fax:281-242-0355
Practice Address - Street 1:14857 SOUTHWEST FWY STE 303
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:281-242-8900
Practice Address - Fax:281-242-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1101525261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy