1013326412 NPI number — HEALTH SERVICES OF NORTH TEXAS, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013326412 NPI number — HEALTH SERVICES OF NORTH TEXAS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH SERVICES OF NORTH TEXAS, INC
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:
1013326412
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/01/2024
NPI Reactivation Date:
03/08/2024

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 N INTERSTATE 35
Provider Second Line Business Mailing Address:
SUITE 312
Provider Business Mailing Address City Name:
DENTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76207-3432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-381-1501
Provider Business Mailing Address Fax Number:
940-566-8059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 S HIGHWAY 78
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
WYLIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-381-1501
Provider Business Practice Location Address Fax Number:
972-801-9015
Provider Enumeration Date:
08/11/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CONTRERAS
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
NAVARRO
Authorized Official Title or Position:
SENIOR PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
940-435-9044

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 339779601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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