Provider Demographics
NPI:1508303231
Name:HOUSTON METHODIST HOSPITAL
Entity Type:Organization
Organization Name:HOUSTON METHODIST HOSPITAL
Other - Org Name:HOUSTON METHODIST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:TERHEMBA
Authorized Official - Last Name:KAJOH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-215-3671
Mailing Address - Street 1:8231 POLARIS POINT LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2867
Mailing Address - Country:US
Mailing Address - Phone:832-215-3671
Mailing Address - Fax:
Practice Address - Street 1:8231 POLARIS POINT LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2867
Practice Address - Country:US
Practice Address - Phone:832-215-3671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132866282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital