1164442752 NPI number — FPT, INC.

Table of content: (NPI 1164442752)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164442752 NPI number — FPT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FPT, 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:
1164442752
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1022 HWY 78 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMERSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-784-6533
Provider Business Mailing Address Fax Number:
972-782-8415

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1022 HWY 78 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMERSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-784-6533
Provider Business Practice Location Address Fax Number:
972-782-8415
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FURR
Authorized Official First Name:
SHAWN
Authorized Official Middle Name:
RENEA
Authorized Official Title or Position:
LPT/ VICE PRESIDENT
Authorized Official Telephone Number:
972-784-6533

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1065126 , 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: 0008MR . This is a "BCBS GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8T4271 . This is a "BCBS INDIVIDUAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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