1265807333 NPI number — BRIGHT FUTURE PEDIATRICS P L L C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265807333 NPI number — BRIGHT FUTURE PEDIATRICS P L L C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHT FUTURE PEDIATRICS P L L C
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:
HYTHAM H FADL SOLE MBR
Provider Other Organization Name Type Code:
3
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:
1265807333
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1125 S LINDEN RD STE 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48532-4069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-262-2150
Provider Business Mailing Address Fax Number:
810-732-3199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 S LINDEN RD STE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-4069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-262-2150
Provider Business Practice Location Address Fax Number:
810-732-3199
Provider Enumeration Date:
12/01/2015

Additional Information

Authorized Official

Authorized Official Last Name:
FADL
Authorized Official First Name:
HYTHAM
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
810-394-0688

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com