Provider Demographics
NPI: | 1902614332 |
---|---|
Name: | HOUSTON METHODIST SPECIALTY PHYSICIANS |
Entity type: | Organization |
Organization Name: | HOUSTON METHODIST SPECIALTY PHYSICIANS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VP REVENUE CYCLE OPERATIONS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PREMETZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 281-414-6055 |
Mailing Address - Street 1: | 7550 GREENBRIAR DR STE 600 |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77030-4508 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 281-414-6055 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7550 GREENBRIAR DR STE 600 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77030-4508 |
Practice Address - Country: | US |
Practice Address - Phone: | 281-414-6055 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | TMH PHYSICIAN ASSOCIATES PLLC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2024-12-18 |
Last Update Date: | 2024-12-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 207LC0200X | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | Group - Multi-Specialty |
No | 207LH0002X | Allopathic & Osteopathic Physicians | Anesthesiology | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 202569406 | Medicaid |