Provider Demographics
NPI:1881870954
Name:CHCA MAINLAND, LP
Entity type:Organization
Organization Name:CHCA MAINLAND, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-938-5186
Mailing Address - Street 1:1125 HIGHWAY 3 N
Mailing Address - Street 2:SUITE 180
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-4048
Mailing Address - Country:US
Mailing Address - Phone:409-938-5665
Mailing Address - Fax:409-938-5669
Practice Address - Street 1:1125 HIGHWAY 3 N
Practice Address - Street 2:SUITE 180
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-4048
Practice Address - Country:US
Practice Address - Phone:409-938-5665
Practice Address - Fax:409-938-5669
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHCA MAINLAND, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000793261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine