1407089683 NPI number — VFAM PLLC

Table of content: (NPI 1407089683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407089683 NPI number — VFAM PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VFAM PLLC
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:
ADHD CENTER OF NORTH DALLAS
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:
1407089683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2459 E HEBRON PKWY
Provider Second Line Business Mailing Address:
SUITE # 130
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75010-4427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-428-7000
Provider Business Mailing Address Fax Number:
972-395-7119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2459 E HEBRON PKWY
Provider Second Line Business Practice Location Address:
SUITE # 130
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75010-4427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-428-7000
Provider Business Practice Location Address Fax Number:
972-395-7119
Provider Enumeration Date:
09/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
NAZ
Authorized Official First Name:
FARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
972-395-8600

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: L0446 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0804X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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