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Memorial Hermann Credentialing
Application Request
Before an application can be released, you must first complete an Application Request. (If you are an Allied Health Professional, please call Central Credentialing directly at 713-448-6464.)
Follow the instructions below:
- Download the Application Request Form.
- Download any additional forms for all facilities where you will be applying.
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Complete, sign and fax or mail forms along with the required documentation to:
Central Credentialing
9401 Southwest Fwy., Ste. 403A
Houston, TX 77074
Fax: 713-448-6570 or 713-448-6580
If you have any questions, please contact Central Credentialing at 713-448-6464 or Memorial.Credentialing@memorialhermann.org.
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Application Request |