1235681263 NPI number — TRINITY HEALTH AND FAMILY PRACTICE

Table of content: BENJAMIN LEWIS DUNKLEY DPT (NPI 1699084848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235681263 NPI number — TRINITY HEALTH AND FAMILY PRACTICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY HEALTH AND FAMILY PRACTICE
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:
1235681263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16430 W LAKE HOUSTON PKWY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77044-1875
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16430 W LAKE HOUSTON PKWY
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77044-1875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-454-7777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCAIN
Authorized Official First Name:
CASEY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-704-8493

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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