1043729429 NPI number — NEW HORIZON WOMEN'S HEALTHCARE, PA

Table of content: (NPI 1043729429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043729429 NPI number — NEW HORIZON WOMEN'S HEALTHCARE, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HORIZON WOMEN'S HEALTHCARE, PA
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:
1043729429
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 OLYMPIC PLAZA CIR STE 503
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TYLER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75701-1952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-520-4706
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 OLYMPIC PLAZA CIR
Provider Second Line Business Practice Location Address:
SUITE 503
Provider Business Practice Location Address City Name:
TYLER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-520-4706
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
MD-PRESIDENT
Authorized Official Telephone Number:
903-520-4706

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  J6479 , 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)





Copyright © 2007-2025 www.npivalidator.com