Provider Demographics
NPI:1093818007
Name:FIRST STREET HOSPITAL, LP
Entity Type:Organization
Organization Name:FIRST STREET HOSPITAL, LP
Other - Org Name:FIRST SURGICAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCDONOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-275-1111
Mailing Address - Street 1:4801 BISSONNET
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4028
Mailing Address - Country:US
Mailing Address - Phone:713-275-1111
Mailing Address - Fax:713-275-1102
Practice Address - Street 1:4801 BISSONNET
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4028
Practice Address - Country:US
Practice Address - Phone:713-275-1111
Practice Address - Fax:713-275-1102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST SURGICAL PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-06
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008401282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX670029Medicare UPIN