Organization
THE COMMUNITY HOSPITAL OF BRAZOSPORT
Active
Other names
CHI St Luke's Health Brazosport, Brazosport Memorial Hospital &Brazosport Regional Health System
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TRAUTMAN (PRESIDENT)
(979) 285-1802
Entity
Organization
Contact information
Practice address
100 MEDICAL DR, LAKE JACKSON, TX 77566
(979) 297-4411
(979) 285-1730
Mailing address
100 MEDICAL DR, LAKE JACKSON, TX 77566
(979) 297-4411
(979) 285-1730
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
000436
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021787901
—
TX
05
—
112671602
—
TX
05
—
112671604
—
TX
05
—
112764902
—
TX
01
—
55805
AMERICAID
—
01
—
6541150
AETNA
—
01
—
HH0471
BLUE CROSS
TX
01
—
HH362S
BLUE CROSS SKILLED UNIT
TX
Enumeration date
01/09/2006
Last updated
03/13/2024
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