Basic Information
| Provider Information | |||||||||
| NPI: | 1508868639 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RENAISSANCE HOSPITAL TERRELL INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RENAISSANCE HOSPITAL TERRELL INC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14440 JOHN F KENNEDY BLVD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770325300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328861900 | ||||||||
| FaxNumber: | 2812271139 | ||||||||
| Practice Location | |||||||||
| Address1: | 1551 HIGHWAY 34 S | ||||||||
| Address2: | |||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751604833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725516820 | ||||||||
| FaxNumber: | 9725516901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 02/01/2008 | ||||||||
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| AuthorizedOfficialLastName: | SMESNY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8328861900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 008486 | TX | Y | Hospitals | General Acute Care Hospital |
No ID Information.