Basic Information
| Provider Information | |||||||||
| NPI: | 1215060546 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 EAST BORDER | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175708500 | ||||||||
| FaxNumber: | 8175708199 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 N. BELKNAP STREET | ||||||||
| Address2: | |||||||||
| City: | STEPHENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 764013415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2549651556 | ||||||||
| FaxNumber: | 2549651591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | LEU | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2549651508 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 11/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 000256 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
ID Information
| ID | Type | State | Issuer | Description | 121794502 | 05 | TX | MEDICAID |