Basic Information
Provider Information
NPI: 1902983000
EntityType: 2
ReplacementNPI:  
OrganizationName: HARRIS COUNTY HOSPITAL DISTRICT
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 4800 FOURNACE PL STE 600W
Address2:  
City: BELLAIRE
State: TX
PostalCode: 774012324
CountryCode: US
TelephoneNumber: 3464260478
FaxNumber: 8324872766
Practice Location
Address1: 1504 TAUB LOOP
Address2:  
City: HOUSTON
State: TX
PostalCode: 770301608
CountryCode: US
TelephoneNumber: 7138734925
FaxNumber: 7138734944
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 06/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NIKITIN
AuthorizedOfficialFirstName: VICTORIA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EVP, CFO
AuthorizedOfficialTelephone: 3464260462
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: HARRIS COUNTY HOSPITAL DISTRICT
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
273R00000X000459TXY Hospital UnitsPsychiatric Unit 

No ID Information.


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