1629080007 NPI number — BIRTH AND WOMENS CENTER

Table of content: (NPI 1629080007)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629080007 NPI number — BIRTH AND WOMENS CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIRTH AND WOMENS CENTER
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:
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:
1629080007
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3100 SWISS AVE
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:
75204-6025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-821-8190
Provider Business Mailing Address Fax Number:
214-821-9040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 SWISS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75204-6025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-821-8190
Provider Business Practice Location Address Fax Number:
214-821-9040
Provider Enumeration Date:
08/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOETTCHER
Authorized Official First Name:
CHERIE
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
DIRECTOR/CERTIFIED NURSE-MIDWIFE
Authorized Official Telephone Number:
214-821-8190

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  2-48188 , 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: HH1606 . This is a "BCBS PROVIDER ID - BWC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4451337 . This is a "AETNA PROVIDER # - CNM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4581569 . This is a "AETNA PROVIDER ID - BWC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 86N553 . This is a "BCBS ID # - CNM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com