Provider Demographics
NPI:1730281585
Name:HSMTX/SUGAR LAND LLC
Entity type:Organization
Organization Name:HSMTX/SUGAR LAND LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:LEN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-843-5038
Mailing Address - Street 1:333 MATLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3241
Mailing Address - Country:US
Mailing Address - Phone:281-491-2226
Mailing Address - Fax:
Practice Address - Street 1:333 MATLAGE WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-491-2226
Practice Address - Fax:281-242-3121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116269314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159510001OtherTEXAS PROVIDER IDENTIFIER
TX001004440Medicaid
TX159510001OtherTEXAS PROVIDER IDENTIFIER