Provider Demographics
NPI:1134328545
Name:ST. MARY'S HEALTHCARE,INC.
Entity Type:Organization
Organization Name:ST. MARY'S HEALTHCARE,INC.
Other - Org Name:ST. MARY'S HEALTHCARE, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:OHAEJESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-783-8989
Mailing Address - Street 1:7211 REGENCY SQUARE BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3138
Mailing Address - Country:US
Mailing Address - Phone:713-783-8989
Mailing Address - Fax:713-783-8997
Practice Address - Street 1:7211 REGENCY SQUARE BLVD STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3138
Practice Address - Country:US
Practice Address - Phone:713-783-8989
Practice Address - Fax:713-783-8997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. MARY'S HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-16
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008911251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673181Medicare PIN