Provider Demographics
NPI:1851439137
Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Entity Type:Organization
Organization Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Other - Org Name:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH OCCUPATIONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-250-3722
Mailing Address - Street 1:P.O. BOX 2526
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76113-2526
Mailing Address - Country:US
Mailing Address - Phone:817-820-0235
Mailing Address - Fax:817-878-5250
Practice Address - Street 1:1512 PENNSYLVANIA AVENUE
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:817-820-0235
Practice Address - Fax:817-878-5250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-01
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDF4504261QX0100X
TX000235261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB88257Medicare UPIN