Provider Demographics
NPI:1497482764
Name:THE MENNINGER CLINIC
Entity Type:Organization
Organization Name:THE MENNINGER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:713-275-5004
Mailing Address - Street 1:12301 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-6207
Mailing Address - Country:US
Mailing Address - Phone:713-275-5400
Mailing Address - Fax:713-275-5109
Practice Address - Street 1:12301 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-6207
Practice Address - Country:US
Practice Address - Phone:713-275-5400
Practice Address - Fax:713-275-5109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MENNINGER CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital