Provider Demographics
NPI:1174576698
Name:CHCA BAYSHORE LP
Entity type:Organization
Organization Name:CHCA BAYSHORE LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGOULAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-440-1000
Mailing Address - Street 1:4000 SPENCER HWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1202
Mailing Address - Country:US
Mailing Address - Phone:713-359-1000
Mailing Address - Fax:713-359-1004
Practice Address - Street 1:4000 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1202
Practice Address - Country:US
Practice Address - Phone:713-359-1000
Practice Address - Fax:713-359-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
374018500OtherUS DEPT LABOR
564889OtherHEALTHLINK
TXHH0541OtherBCBS
TX020817501Medicaid
117736OtherAETNA HMO
564889OtherHEALTHLINK