| St Hope Foundation Inc | |
|
1414 S Frazier St Suite 106 Conroe TX 77301-4453 | |
| (936) 441-2440 | |
| (800) 249-5020 |
| Full Name | St Hope Foundation Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1414 S Frazier St, Conroe, Texas |
| Authorized Official Name and Position | Rodney Neil Goodie (CEO) |
| Authorized Official Contact | 7137781300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Hope Foundation Inc 6200 Savoy Drive Suite 540 Houston TX 77036-3338 Ph: (713) 778-1300 | St Hope Foundation Inc 1414 S Frazier St Suite 106 Conroe TX 77301-4453 Ph: (936) 441-2440 |
| NPI Number | 1265581144 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 05/19/2021 |
| Medicare PECOS PAC ID | 4880508878 |
|---|---|
| Medicare Enrollment ID | O20170905000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265581144 | NPI | - | NPPES |
| 1567299-03 | Medicaid | TX | |
| 0021KK | Other | TX | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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