1487759346 NPI number — DARLA JALANE EDDINS CRNA

Table of content: DARLA JALANE EDDINS CRNA (NPI 1487759346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487759346 NPI number — DARLA JALANE EDDINS CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EDDINS
Provider First Name:
DARLA
Provider Middle Name:
JALANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1487759346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 515 432
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-549-6998
Provider Business Mailing Address Fax Number:
469-737-4313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 OHIO DR
Provider Second Line Business Practice Location Address:
BAYLOR SURGICARE AT PLANO
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-5208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-549-6998
Provider Business Practice Location Address Fax Number:
800-507-7848
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  538008 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 88304U . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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