Basic Information
Provider Information | |||||||||
NPI: | 1396968848 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | TRIUMPH SOUTHWEST LP | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | TRIUMPH HOSPITAL WEST HOUSTON | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7333 NORTH FWY | ||||||||
Address2: | SUITE 500 | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770761300 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7138078686 | ||||||||
FaxNumber: | 7138078604 | ||||||||
Practice Location | |||||||||
Address1: | 8850 LONG POINT RD | ||||||||
Address2: | 6TH FLOOR | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770553006 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7133657800 | ||||||||
FaxNumber: | 7134656633 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/11/2007 | ||||||||
LastUpdateDate: | 08/22/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | WOLLARD | ||||||||
AuthorizedOfficialFirstName: | VIRGINIA | ||||||||
AuthorizedOfficialMiddleName: | L | ||||||||
AuthorizedOfficialTitleorPosition: | VP, QUALITY AND COMPLIANCE | ||||||||
AuthorizedOfficialTelephone: | 7138078686 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MS. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | RN, MBA | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282E00000X | 007927 | TX | Y |   | Hospitals | Long Term Care Hospital |   |
No ID Information.