Basic Information
| Provider Information | |||||||||
| NPI: | 1467590851 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HARRIS METHODIST HEB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 HOSPITAL PKWY | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760226913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176854000 | ||||||||
| FaxNumber: | 8176854469 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 HOSPITAL PKWY | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760226913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176854000 | ||||||||
| FaxNumber: | 8176854469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | KING | ||||||||
| AuthorizedOfficialFirstName: | KIRK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8176854607 | ||||||||
| 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 | 282N00000X | 000182 | TX | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | H04506392 | 05 | TX | MEDICAID |