Provider Demographics
NPI:1992869846
Name:ST HOPE FOUNDATION INC
Entity type:Organization
Organization Name:ST HOPE FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:MIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAM-COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-778-1300
Mailing Address - Street 1:6200 SAVOY DRIVE
Mailing Address - Street 2:SUITE 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3338
Mailing Address - Country:US
Mailing Address - Phone:713-778-1300
Mailing Address - Fax:281-778-0827
Practice Address - Street 1:14815 SOUTHWEST FWY
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:281-277-8571
Practice Address - Fax:281-277-8564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4218075-01Medicaid
TX0021KKOtherBLUE CROSS/BLUE SHIELD
TX156729902Medicaid
TX0021KKOtherBLUE CROSS/BLUE SHIELD