Basic Information
| Provider Information | |||||||||
| NPI: | 1477583334 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW MEDICAL HORIZONS II, LTD. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CYPRESS FAIRBANKS MEDICAL CENTER HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 849762 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752849762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819493615 | ||||||||
| FaxNumber: | 2818905341 | ||||||||
| Practice Location | |||||||||
| Address1: | 10655 STEEPLETOP DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770654222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818904285 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 03/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | ARMIN | ||||||||
| AuthorizedOfficialFirstName: | CRAIG | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF GOVT PROGRAMS, TENET | ||||||||
| AuthorizedOfficialTelephone: | 8184362267 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | 282N00000X | 000606 | TX | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 742054101 | 01 | FORTIS JOHN ALDEN LIFE IN | OTHER | 112718502 | 05 | TX | MEDICAID | 603334 | 01 | AETNA US HEALTHCARE (NATI | OTHER | 742054101 | 01 | HUMANA | OTHER | 9540 | 01 | COVENTRY HEALTH CARE LOUI | OTHER | HH0768 | 01 | BCBS OF TEXAS | OTHER | 112718503 | 05 | TX | MEDICAID | 1760048 | 05 | LA | MEDICAID | 74-2054101 | 01 | PPONEXT | OTHER | 450716B000000 | 01 | SECTION 1011 | OTHER |