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DSH450844G HOUSTON METHODIST WILLOWBROOK HOSPITAL (Active)
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Main Details
Name
HOUSTON METHODIST WILLOWBROOK HOSPITAL
Subdivision Name
Houston Methodist ECC in Spring - Radiology - Radiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450844G
Medicare Provider Number
450844
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
9/13/2024
Last Recertification Date
Contacts
Authorizing Official
Houston Methodist Willowbrook Hospital
Julie K Peterson, Vice President/Chief Operating Officer
(281) 737-2115
Primary Contact
Houston Methodist
Daniel Metzen, System Director of Pharmacy
(713) 441-2141
Addresses
Street Address
5303 FM2920 RD
Spring, TX 77388-3006
Billing Address
Houston Methodist Willowbrook Hospital
18220 State Highway 249
Houston, TX 77070-4347
Comments
Medicaid Billing
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