Thank you for your interest in Memorial Hermann Health Solutions, Inc., and Memorial Hermann Health Insurance Company. If you would like to become a network member, please click here for a Request for Participation form.
You will need the following information in order to complete this form:
- Provider/facility/urgent care/ancillary name
- Service address with telephone, fax and email address
- Mailing address, if different than service address
- Taxpayer Identification Number (TIN)
- NPI number
For questions or information about joining the Memorial Hermann Provider Network, please contact the Provider Relations Department at (713) 338-4801 or email ProviderServices@memorialhermann.org.
One of our contracting representatives will review your faxed Request for Participation and evaluate against current need to service the membership in a specific geographical area. You may be contacted for additional information.
Dependent on current network needs, state and federal regulations, and other factors, one of our representatives may contact you to initiate a participation agreement.
At this point, you will be instructed to complete one of the following:
The application must be returned with the signed contracts and all supporting credentialing documentation (e.g., licensure, malpractice insurance, certifications, etc.) to initiate the credentialing process.