Provider Demographics
NPI:1295764330
Name:BAPTIST HOSPITALS OF SOUTHEAST TEXAS
Entity type:Organization
Organization Name:BAPTIST HOSPITALS OF SOUTHEAST TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:PARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-212-5012
Mailing Address - Street 1:P O BOX 974599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-4599
Mailing Address - Country:US
Mailing Address - Phone:409-212-6149
Mailing Address - Fax:409-212-6063
Practice Address - Street 1:608 STRICKLAND DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4717
Practice Address - Country:US
Practice Address - Phone:409-212-6149
Practice Address - Fax:409-212-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000121282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136488705OtherAMERIGROUP
TX500013OtherMHHNP
TX450005OtherWORKMANCOMP
TX136488703Medicaid
TX136488705Medicaid
TXHH0495OtherBLUE CROSS OF TEXAS
LA1731943Medicaid
TXHH0495OtherBLUE CROSS OF TEXAS
TX=========OtherCHAMPUS