Provider Demographics
NPI:1083631972
Name:MEMORIAL HERMANN HEALTH SYSTEM
Entity Type:Organization
Organization Name:MEMORIAL HERMANN HEALTH SYSTEM
Other - Org Name:MEMORIAL HERMANN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PATIENT BUSINESS SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-338-7413
Mailing Address - Street 1:PO BOX 301162
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75303-1162
Mailing Address - Country:US
Mailing Address - Phone:713-338-7300
Mailing Address - Fax:713-338-7303
Practice Address - Street 1:16538 AIR CENTER BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-5144
Practice Address - Country:US
Practice Address - Phone:281-784-7550
Practice Address - Fax:281-784-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007860251E00000X
TX21498251F00000X
TX0059100332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4319300001Medicare NSC