Provider Demographics
NPI:1295363497
Name:MEMORIAL HERMANN HOSPITAL BASED PHYSICIAN GROUP
Entity Type:Organization
Organization Name:MEMORIAL HERMANN HOSPITAL BASED PHYSICIAN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHYSICIAN EXECUTIVE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-500-7878
Mailing Address - Street 1:929 GESSNER RD STE 2700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2593
Mailing Address - Country:US
Mailing Address - Phone:713-242-2712
Mailing Address - Fax:713-242-2473
Practice Address - Street 1:929 GESSNER RD STE 2700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2593
Practice Address - Country:US
Practice Address - Phone:713-242-2712
Practice Address - Fax:713-242-2473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty