1124291661 NPI number — QUESTCARE OBSTETRICS PLLC

Table of content: (NPI 1124291661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124291661 NPI number — QUESTCARE OBSTETRICS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUESTCARE OBSTETRICS PLLC
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:
1124291661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 678484
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:
75267-8484
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-758-3598
Provider Business Mailing Address Fax Number:
972-599-9604

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7777 FOREST LN
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:
75230-2505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-217-1911
Provider Business Practice Location Address Fax Number:
214-217-1912
Provider Enumeration Date:
04/04/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LIEBER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
214-217-1911

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 195608801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0088RD . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".