Provider Demographics
NPI:1124537287
Name:MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION
Entity Type:Organization
Organization Name:MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION
Other - Org Name:MEMORIAL HERMANN HEALTH CENTERS FOR SCHOOLS--ELROD CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMMUNITY HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-338-5983
Mailing Address - Street 1:909 FROSTWOOD DR STE 2.205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-5983
Mailing Address - Fax:713-338-4542
Practice Address - Street 1:6230 DUMFRIES DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4603
Practice Address - Country:US
Practice Address - Phone:713-771-1805
Practice Address - Fax:713-771-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care