Provider Demographics
NPI:1902453970
Name:ST. MICHAEL'S MEDICAL HOSPITAL LLC
Entity Type:Organization
Organization Name:ST. MICHAEL'S MEDICAL HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CNO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-757-0149
Mailing Address - Street 1:16000 SOUTHWEST FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2674
Mailing Address - Country:US
Mailing Address - Phone:281-980-4357
Mailing Address - Fax:281-980-4445
Practice Address - Street 1:16000 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2674
Practice Address - Country:US
Practice Address - Phone:281-980-4357
Practice Address - Fax:281-980-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital