# AVICENNA HOSPITAL - SPRING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912861295
- **Authorized official:** MR. ROSS MATLACK III FACHE (PRESIDENT)
- **Authorized official phone:** (419) 577-8983

## Contact information

- **Practice address:** 20635 KUYKENDAHL RD, SPRING, TX 77379-3533
- **Practice address phone:** (281) 317-1118
- **Mailing address:** 1601 HIGHWAY 13 E STE 255, BURNSVILLE, MN 55337-6865
- **Mailing address phone:** (281) 317-1118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 12/11/2025
- **Last updated:** 12/11/2025