Provider Demographics
NPI:1982653473
Name:LAREDO TEXAS HOSPITAL COMPANY LP
Entity Type:Organization
Organization Name:LAREDO TEXAS HOSPITAL COMPANY LP
Other - Org Name:LAREDO MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHYSICAN BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-778-1502
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 E SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5474
Practice Address - Country:US
Practice Address - Phone:956-796-2810
Practice Address - Fax:956-796-2902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAREDO TEXAS HOSPITAL COMPANY LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 363LF0000X
TX2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162033806OtherTEXAS HEALTH STEPS
TXDC7387OtherRAILROAD MEDICARE
TX162033805Medicaid
TX162033807OtherCSHCN
TXDC7387OtherRAILROAD MEDICARE