Provider Demographics
NPI:1386827558
Name:MEMORIAL HERMANN HOSPITAL SYSTEM
Entity Type:Organization
Organization Name:MEMORIAL HERMANN HOSPITAL SYSTEM
Other - Org Name:MEMORIAL HERMANN MEMORIAL CITY RADIATION THERAPY RR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REVENUE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:H.
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:BROWNAWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-242-2785
Mailing Address - Street 1:PO BOX 201367
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-1367
Mailing Address - Country:US
Mailing Address - Phone:713-338-4127
Mailing Address - Fax:713-338-4158
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2420
Practice Address - Country:US
Practice Address - Phone:713-242-3700
Practice Address - Fax:713-338-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX470000761Medicare PIN