1093930083 NPI number — TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO

Table of content: (NPI 1093930083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093930083 NPI number — TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO
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:
1093930083
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 910156
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:
75391-0156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-890-6034
Provider Business Mailing Address Fax Number:
682-236-0103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6110 W PARKER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-7939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-981-8301
Provider Business Practice Location Address Fax Number:
972-981-8558
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MINCHER
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VP REVENUE CYCLE
Authorized Official Telephone Number:
682-236-3013

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X , with the licence number:  000720 , 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: HO4507710 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 343909 . This is a "VALUE OPTIONS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH6569 . This is a "BC FULL DAY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH0865 . This is a "BC INPATIENT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 6546680 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH3865 . This is a "BC INPATIENT CHEM DEP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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