Provider Demographics
NPI:1528231917
Name:SAN JACINTO METHODIST HOSPITAL
Entity Type:Organization
Organization Name:SAN JACINTO METHODIST HOSPITAL
Other - Org Name:HOUSTON METHODIST SAN JACINTO HOSPTIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRET
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-667-6022
Mailing Address - Street 1:4401 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2122
Mailing Address - Country:US
Mailing Address - Phone:281-420-8600
Mailing Address - Fax:
Practice Address - Street 1:1700 JAMES BOWIE DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3302
Practice Address - Country:US
Practice Address - Phone:281-420-8651
Practice Address - Fax:281-428-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0405273R00000X, 273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
45S424Medicare Oscar/Certification
45T424Medicare Oscar/Certification