Provider Demographics
NPI:1073727939
Name:TEXAS HEALTHSPRING, LLC PDP S5740
Entity Type:Organization
Organization Name:TEXAS HEALTHSPRING, LLC PDP S5740
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:RJ
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:832-553-3375
Mailing Address - Street 1:2900 N. LOOP WEST
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8815
Mailing Address - Country:US
Mailing Address - Phone:832-553-3300
Mailing Address - Fax:832-553-3584
Practice Address - Street 1:2900 N. LOOP WEST
Practice Address - Street 2:SUITE 1300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8815
Practice Address - Country:US
Practice Address - Phone:832-553-3300
Practice Address - Fax:832-553-3584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28095786302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS5740Medicare ID - Type Unspecified2895786