Provider Demographics
NPI:1013131077
Name:TRIUMPH HOSPITAL OF E HOUSTON LP
Entity Type:Organization
Organization Name:TRIUMPH HOSPITAL OF E HOUSTON LP
Other - Org Name:TRIUMPH HOSPITAL BAYTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7563
Mailing Address - Street 1:680 S. 4TH STREET
Mailing Address - Street 2:KLIVE 5 - REIMBURSEMENT
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206
Mailing Address - Country:US
Mailing Address - Phone:502-596-7301
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:1700 JAMES BOWIE DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3302
Practice Address - Country:US
Practice Address - Phone:281-420-7800
Practice Address - Fax:281-420-7841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007204282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149047601Medicaid
TX149047601Medicaid