1578612024 NPI number — DRS. DYER & KOLATH, P.A.

Table of content: (NPI 1578612024)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578612024 NPI number — DRS. DYER & KOLATH, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. DYER & KOLATH, P.A.
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:
1578612024
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
820 E CARTWRIGHT RD STE 140
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESQUITE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75149-6063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-329-2442
Provider Business Mailing Address Fax Number:
972-329-2452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 E CARTWRIGHT RD STE 140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESQUITE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75149-6063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-329-2442
Provider Business Practice Location Address Fax Number:
972-329-2452
Provider Enumeration Date:
01/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DYER
Authorized Official First Name:
CLYDE
Authorized Official Middle Name:
GREGORY
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
972-329-2442

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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