Provider Demographics
NPI:1396968848
Name:TRIUMPH SOUTHWEST LP
Entity type:Organization
Organization Name:TRIUMPH SOUTHWEST LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, QUALITY AND COMPLIANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:713-807-8686
Mailing Address - Street 1:7333 NORTH FWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1300
Mailing Address - Country:US
Mailing Address - Phone:713-807-8686
Mailing Address - Fax:713-807-8604
Practice Address - Street 1:8850 LONG POINT RD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3006
Practice Address - Country:US
Practice Address - Phone:713-365-7800
Practice Address - Fax:713-465-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007927282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
452080Medicare ID - Type Unspecified