Provider Demographics
NPI:1295097624
Name:CAMBRIDGE HOSPITAL LLC
Entity type:Organization
Organization Name:CAMBRIDGE HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-1155
Mailing Address - Street 1:7505 FANNIN ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1913
Mailing Address - Country:US
Mailing Address - Phone:713-790-1155
Mailing Address - Fax:713-790-0618
Practice Address - Street 1:7601 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1905
Practice Address - Country:US
Practice Address - Phone:713-790-1155
Practice Address - Fax:713-790-0618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100151283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital