Provider Demographics
NPI:1720088412
Name:TRIUMPH SOUTHWEST, LP
Entity Type:Organization
Organization Name:TRIUMPH SOUTHWEST, LP
Other - Org Name:KINDRED HOSPITAL SUGAR LAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-253-5121
Mailing Address - Street 1:1550 FIRST COLONY BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4000
Mailing Address - Country:US
Mailing Address - Phone:281-275-6000
Mailing Address - Fax:281-491-7255
Practice Address - Street 1:1550 FIRST COLONY BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4000
Practice Address - Country:US
Practice Address - Phone:281-275-6000
Practice Address - Fax:281-491-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007927282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157203401Medicaid
TXHH1017OtherBLUE CROSS
TXHH1017OtherBLUE CROSS