Basic Information
| Provider Information | |||||||||
| NPI: | 1891999314 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RENAISSANCE HOSPITALS INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RENAISSANCE HOSPITAL GROVES | ||||||||
| 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: | 2812271142 | ||||||||
| Practice Location | |||||||||
| Address1: | 5500 39TH ST | ||||||||
| Address2: | |||||||||
| City: | GROVES | ||||||||
| State: | TX | ||||||||
| PostalCode: | 776192905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4099625733 | ||||||||
| FaxNumber: | 4099635120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SMESNY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8328861900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 000515 | TX | Y | Hospitals | General Acute Care Hospital |
No ID Information.