1194728402 NPI number — CITY OF GRAND PRAIRIE

Table of content: (NPI 1194728402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194728402 NPI number — CITY OF GRAND PRAIRIE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF GRAND PRAIRIE
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:
GRAND PRAIRIE FIRE DEPARTMENT
Provider Other Organization Name Type Code:
5
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:
1194728402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1525 ARKANSAS LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75052-7401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-237-8300
Provider Business Mailing Address Fax Number:
972-237-8309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1525 ARKANSAS LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND PRAIRIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75052-7401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-237-8300
Provider Business Practice Location Address Fax Number:
972-237-8309
Provider Enumeration Date:
05/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HART
Authorized Official First Name:
TOM
Authorized Official Middle Name:
Authorized Official Title or Position:
CITY MANAGER
Authorized Official Telephone Number:
972-237-8301

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  300276 , 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: 000746001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590014260 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: AMB559 . This is a "COMMERCIAL INSURANCE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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