Provider Demographics
NPI:1700258969
Name:OAKBEND MEDICAL CENTER
Entity Type:Organization
Organization Name:OAKBEND MEDICAL CENTER
Other - Org Name:OAKBEND MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LENFANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-341-3000
Mailing Address - Street 1:1705 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3246
Mailing Address - Country:US
Mailing Address - Phone:281-341-3000
Mailing Address - Fax:281-341-4849
Practice Address - Street 1:3000 RICHMOND AVE STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3188
Practice Address - Country:US
Practice Address - Phone:713-621-2486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAKBEND MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH0474OtherBCBSTX
TX6542270OtherAETNA
TX55810OtherAMERIGROUP
TX127303901Medicaid
TX127303903Medicaid
TX127303903Medicaid