1154328870 NPI number — DR. JOSHUA S HOOPER OD

Table of content: DR. JOSHUA S HOOPER OD (NPI 1154328870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154328870 NPI number — DR. JOSHUA S HOOPER OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOPER
Provider First Name:
JOSHUA
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
Provider Gender Code:
M

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:
1154328870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 846098
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:
75284-6098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-324-6450
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1327 TROUP HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TYLER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75701-4443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-531-4733
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  6589TG , 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: 925395 . This is a "WEB-TPA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "TEXAS COMMUNITY CARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "TEXAS TRUE CHOICE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 11450424 . This is a "AETNA TRS CARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 202043539 . This is a "TRICARE SOUTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5451470001 . This is a "STERLING OPTION I" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "HEALTHFIRST TPA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 11450424 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 81256Q . This is a "BLUE CROSS BLUE SHIELD GOVERNMENT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "SUPERIOR VISION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5451470001 . This is a "CIGNA GOVERNMENT SERVICES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 921841 . This is a "BLOCK VISION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 9370971 . This is a "PHCS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 22704 . This is a "NATIONAL VISION ADMINISTRATORS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 170498302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 22704 . This is a "ALWAYS VISION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5451470001 . This is a "STERLING OPTION II" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "VISION SERVICE PLAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0038FF . This is a "PRINICIPAL FINANCIAL GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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