Provider Demographics
NPI:1639101108
Name:TH HEALTHCARE, LTD.
Entity type:Organization
Organization Name:TH HEALTHCARE, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERCROMBIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-620-7095
Mailing Address - Street 1:PO BOX 849775
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-9775
Mailing Address - Country:US
Mailing Address - Phone:936-560-3186
Mailing Address - Fax:936-598-4237
Practice Address - Street 1:602 HURST ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3414
Practice Address - Country:US
Practice Address - Phone:936-659-8278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000423282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133465802Medicaid
TX133465808Medicaid
LA1734705Medicaid
114113OtherCHIP SUPERIOR HEALTH PLAN
TX133465809Medicaid
000412OtherHUMANA
077747670OtherAETNA US HEALTHCARE
HH0609OtherBCBS OF TEXAS
TX133465809Medicaid