Provider Demographics
| NPI: | 1003985102 |
|---|---|
| Name: | MEMORIAL HERMANN MEDICAL GROUP |
| Entity type: | Organization |
| Organization Name: | MEMORIAL HERMANN MEDICAL GROUP |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EVP & PHYSICIAN CHIEF EXECUTIVE |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MCCARTHY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 713-338-5519 |
| Mailing Address - Street 1: | 920 FROSTWOOD DR STE 2200 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77024-2314 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-338-4523 |
| Mailing Address - Fax: | 713-338-5500 |
| Practice Address - Street 1: | 14023 SOUTHWEST FWY |
| Practice Address - Street 2: | |
| Practice Address - City: | SUGAR LAND |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77478-3550 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 281-325-4100 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-11-06 |
| Last Update Date: | 2025-05-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
| No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2080P0206X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | Group - Multi-Specialty |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 00X849 | Medicare PIN | |
| TX | 00Y376 | Medicare PIN | |
| TX | 00X848 | Medicare PIN | |
| TX | 00X978 | Medicare PIN |