Provider Demographics
NPI:1407881808
Name:TH HEALTHCARE ,LTD.
Entity Type:Organization
Organization Name:TH HEALTHCARE ,LTD.
Other - Org Name:PARK PLAZA HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-816-6278
Mailing Address - Street 1:PO BOX 849988
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-9988
Mailing Address - Country:US
Mailing Address - Phone:214-387-6444
Mailing Address - Fax:713-524-6159
Practice Address - Street 1:1313 HERMANN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7005
Practice Address - Country:US
Practice Address - Phone:713-527-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARK PLAZA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-12
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000390273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45S659Medicare Oscar/Certification