Provider Demographics
NPI:1356731020
Name:HMH PHYSICIAN ORGANIZATION
Entity type:Organization
Organization Name:HMH PHYSICIAN ORGANIZATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-291-3411
Mailing Address - Street 1:MSC 250 PO BOX 4345
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4345
Mailing Address - Country:US
Mailing Address - Phone:936-435-7575
Mailing Address - Fax:936-435-7595
Practice Address - Street 1:9516 STE 140 W 1097
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77318-4976
Practice Address - Country:US
Practice Address - Phone:936-435-7575
Practice Address - Fax:936-435-7595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health