1205863263 NPI number — TEXAS ONCOLOGY CARE, PLLC

Table of content: (NPI 1205863263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205863263 NPI number — TEXAS ONCOLOGY CARE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS ONCOLOGY CARE, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GREGORY ECHT, M.D., PLLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205863263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7415 LAS COLINAS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75063-7568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-379-2737
Provider Business Mailing Address Fax Number:
214-379-2759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7415 LAS COLINAS BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75063-7569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-379-2700
Provider Business Practice Location Address Fax Number:
214-379-2750
Provider Enumeration Date:
06/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NIETO
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
214-379-2731

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0203X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1934143-05 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: DN1807 . This is a "RR PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1934143-03 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1934143-06 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".