1437158615 NPI number — DR. CHRISTINA L DELLA NEBBIA PHD

Table of content: DR. CHRISTINA L DELLA NEBBIA PHD (NPI 1437158615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437158615 NPI number — DR. CHRISTINA L DELLA NEBBIA PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELLA NEBBIA
Provider First Name:
CHRISTINA
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

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:
1437158615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 CROSS TIMBERS RD STE 1240
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLOWER MOUND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75028-8866
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-966-1079
Provider Business Mailing Address Fax Number:
972-767-0755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 CROSS TIMBERS RD STE 1240
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLOWER MOUND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75028-8866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-966-1079
Provider Business Practice Location Address Fax Number:
972-767-0755
Provider Enumeration Date:
07/19/2005

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: 103T00000X , with the licence number:  25826 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 25826 , 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: 475469 . This is a "VALUEOPTIONS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00346P . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 253769 . This is a "MHN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7283371 . This is a "AETNA BEHAVIORAL HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 122760 . This is a "SUPERIOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5686812 . This is a "FIRST HEALTH CCN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 144029903 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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