Provider Demographics
NPI:1659559573
Name:ST LUKES COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
Entity Type:Organization
Organization Name:ST LUKES COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
Other - Org Name:ST LUKES SUGAR LAND HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-637-7605
Mailing Address - Street 1:3100 MAIN ST
Mailing Address - Street 2:SUITE 569
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9312
Mailing Address - Country:US
Mailing Address - Phone:281-737-7000
Mailing Address - Fax:832-355-7268
Practice Address - Street 1:1317 LAKE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3997
Practice Address - Country:US
Practice Address - Phone:281-637-7000
Practice Address - Fax:832-355-7268
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. LUKES EPISCOPAL HEALTH SYSTEM CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-01
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX298019501Medicaid
TX298019501Medicaid