Provider Demographics
NPI:1043328222
Name:METHODIST HOSPITAL LEVELLAND
Entity Type:Organization
Organization Name:METHODIST HOSPITAL LEVELLAND
Other - Org Name:COVENANT HOSPITAL LEVELLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-894-4963
Mailing Address - Street 1:1900 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6508
Mailing Address - Country:US
Mailing Address - Phone:806-894-4963
Mailing Address - Fax:806-894-6461
Practice Address - Street 1:1900 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336
Practice Address - Country:US
Practice Address - Phone:806-894-4963
Practice Address - Fax:806-894-6461
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HOSPITAL LEVELLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-28
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000307207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103182100OtherFIRSTCARE/SWL&H/CHIPS
TX13325870502Medicaid
TX13325870502Medicaid