Provider Demographics
NPI:1508868639
Name:RENAISSANCE HOSPITAL TERRELL INC
Entity Type:Organization
Organization Name:RENAISSANCE HOSPITAL TERRELL INC
Other - Org Name:RENAISSANCE HOSPITAL TERRELL INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMESNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-886-1900
Mailing Address - Street 1:14440 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-5300
Mailing Address - Country:US
Mailing Address - Phone:832-886-1900
Mailing Address - Fax:281-227-1139
Practice Address - Street 1:1551 HIGHWAY 34 S
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-4833
Practice Address - Country:US
Practice Address - Phone:972-551-6820
Practice Address - Fax:972-551-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008486282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX450683Medicare ID - Type UnspecifiedPROVIDER NUMBER