1396185484 NPI number — CHRISTOPHER PAUL TREADAWAY

Table of content: CHRISTOPHER PAUL TREADAWAY (NPI 1396185484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396185484 NPI number — CHRISTOPHER PAUL TREADAWAY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TREADAWAY
Provider First Name:
CHRISTOPHER
Provider Middle Name:
PAUL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1396185484
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2317 W UNIVERSITY DR
Provider Second Line Business Mailing Address:
#107
Provider Business Mailing Address City Name:
DENTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76201-1600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-387-9200
Provider Business Mailing Address Fax Number:
940-387-9206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2317 W UNIVERSITY DR
Provider Second Line Business Practice Location Address:
#107
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76201-1600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-387-9200
Provider Business Practice Location Address Fax Number:
940-387-9206
Provider Enumeration Date:
07/03/2013

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: 237700000X , with the licence number:  80615 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237700000X , with the licence number: 11182 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com