Basic Information
Provider Information
NPI: 1629152939
EntityType: 2
ReplacementNPI:  
OrganizationName: TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 E BORDER ST
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760107445
CountryCode: US
TelephoneNumber: 8008906034
FaxNumber:  
Practice Location
Address1: 1600 HOSPITAL PKWY
Address2:  
City: BEDFORD
State: TX
PostalCode: 760226913
CountryCode: US
TelephoneNumber: 8176854011
FaxNumber: 8176854469
Other Information
ProviderEnumerationDate: 10/24/2006
LastUpdateDate: 04/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MINCHER
AuthorizedOfficialFirstName: JEFF
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SENIOR VP REVENUE CYCLE
AuthorizedOfficialTelephone: 6822363013
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
273Y00000X000182TXY Hospital UnitsRehabilitation Unit 

ID Information
IDTypeStateIssuerDescription
13632690605TX MEDICAID


Home