Patient Notebook

Harris County ESD 11 Mobile Healthcare

18334 Stuebner Airline Rd

Spring, TX 77379

Phone: (346) 226 - 8860

Make a Payment

Need to make a payment? Please fill out the information below and hit continue.

Error Summary

Please, correctly fill out all required fields.

1. Patient Information

First Name *

M.I.

Last Name *

Account Number *

Payment Notes

Please notate what this payment is to be applied towards if not paying a statement balance.

Visit Number

Email Address

A receipt will be sent to this email address.

2. Payment Amount

Amount

3. Payment Method

Credit/Debit Card

Bank Account

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel

P (346) 226 - 8860

18334 Stuebner Airline Rd

Spring, TX 77379