Provider Demographics
NPI:1598758765
Name:RIVER OAKS MEDICAL CENTER
Entity Type:Organization
Organization Name:RIVER OAKS MEDICAL CENTER
Other - Org Name:TWELVE OAKS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-623-2500
Mailing Address - Street 1:4203 YOAKUM BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5452
Mailing Address - Country:US
Mailing Address - Phone:713-630-6103
Mailing Address - Fax:713-630-6181
Practice Address - Street 1:4203 YOAKUM BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5452
Practice Address - Country:US
Practice Address - Phone:713-630-6103
Practice Address - Fax:713-630-6181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX450378Medicare Oscar/Certification
TX45S378Medicare ID - Type UnspecifiedPSYCH
TX45T378Medicare ID - Type UnspecifiedREHAB