Provider Demographics
NPI:1821450255
Name:FIRST TEXAS HOSPITAL CY-FAIR LLC
Entity Type:Organization
Organization Name:FIRST TEXAS HOSPITAL CY-FAIR LLC
Other - Org Name:FIRST TEXAS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-315-4829
Mailing Address - Street 1:2941 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9922 LOUETTA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070
Practice Address - Country:US
Practice Address - Phone:844-264-1435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100365OtherSTATE LICENSE
670118Medicare Oscar/Certification