Provider Demographics
NPI:1407990088
Name:PMC HOSPITAL, LLC
Entity Type:Organization
Organization Name:PMC HOSPITAL, LLC
Other - Org Name:ST. LUKE'S PATIENTS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-948-7050
Mailing Address - Street 1:4600 EAST SAM HOUSTON PKWY SOUTH
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3948
Mailing Address - Country:US
Mailing Address - Phone:713-948-7050
Mailing Address - Fax:713-948-7081
Practice Address - Street 1:4600 EAST SAM HOUSTON PKWY SOUTH
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3948
Practice Address - Country:US
Practice Address - Phone:713-948-7050
Practice Address - Fax:713-948-7081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100081282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX670031Medicare Oscar/Certification