Organization
MEMORIAL HERMANN HEALTH SYSTEM
Active
Other names
Memorial Hermann Northeast Hospital ASC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS LARAWAY (CFO)
(713) 242-2707
Entity
Organization
Contact information
Practice address
18951 N MEMORIAL DR, HUMBLE, TX 77338-4217
(713) 338-4127
(713) 338-4158
Mailing address
PO BOX 301208, DALLAS, TX 75303-1208
(713) 338-4127
(713) 338-4158
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136486104
—
TX
Enumeration date
05/15/2007
Last updated
06/26/2014
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