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DSH670077D HOUSTON METHODIST WEST HOSPITAL (Active)
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Main Details
Name
HOUSTON METHODIST WEST HOSPITAL
Subdivision Name
Houston Methodist ECC at Cinco Ranch Radiology - Radiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH670077D
Medicare Provider Number
670077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/2/2024
Last Recertification Date
Contacts
Authorizing Official
Houston Methodist West Hospital
Kyle R Stanzel, VP & Chief Operating Officer
(832) 522-0300
Primary Contact
Houston Methodist
Daniel Metzen, System Director of Pharmacy
(713) 441-2141
Addresses
Street Address
26000 FM 1093 RD
Richmond, TX 77046-7857
Billing Address
Houston Methodist West Hospital
18500 KATY FWY
Houston, TX 77094-1110
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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