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DSH670077A HOUSTON METHODIST WEST HOSPITAL (Active)
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Main Details
Name
HOUSTON METHODIST WEST HOSPITAL
Subdivision Name
Houston Methodist Emergency Care CE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH670077A
Medicare Provider Number
670077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/30/2022
Last Recertification Date
8/15/2024
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 77406-7857
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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Participating starting 4/1/2018; Terminated on 10/1/2018; Reinstated 10/1/2022.
08/24/2022
April 2025
April 2025
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