Provider Demographics
NPI:1710061023
Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Entity Type:Organization
Organization Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MINCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-236-3013
Mailing Address - Street 1:PO BOX 916063
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76191-6063
Mailing Address - Country:US
Mailing Address - Phone:800-890-6034
Mailing Address - Fax:682-226-0103
Practice Address - Street 1:1301 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2122
Practice Address - Country:US
Practice Address - Phone:817-882-3700
Practice Address - Fax:817-570-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000235273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX021789501Medicaid
TX45T135Medicare Oscar/Certification