Provider Demographics
NPI:1962455816
Name:CHCA CONROE LP
Entity Type:Organization
Organization Name:CHCA CONROE LP
Other - Org Name:CONROE REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-539-7413
Mailing Address - Street 1:504 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2808
Mailing Address - Country:US
Mailing Address - Phone:936-539-1111
Mailing Address - Fax:936-539-5620
Practice Address - Street 1:504 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2808
Practice Address - Country:US
Practice Address - Phone:936-539-1111
Practice Address - Fax:936-539-5620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1737135Medicaid
565010OtherHEALTHLINK
TX022498201Medicaid
TX103127100OtherVALLEY
513827OtherAETNA HMO
TXHH0027OtherBCBS
TX020841501Medicaid
166526600OtherUS DEPT LABOR
LA1737135Medicaid