Provider Demographics
NPI:1730442526
Name:SAN FELIPE MEDICAL CENTER LLC
Entity type:Organization
Organization Name:SAN FELIPE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-292-2450
Mailing Address - Street 1:10077 GROGANS MILL RD
Mailing Address - Street 2:PARKWOOD ONE SUITE 100
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1000
Mailing Address - Country:US
Mailing Address - Phone:281-292-2450
Mailing Address - Fax:
Practice Address - Street 1:1635 S VOSS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2622
Practice Address - Country:US
Practice Address - Phone:713-972-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care