1689600322 NPI number — DIAGNOSTIC ASSOCIATES OF NORTH TEXAS PA

Table of content: LORI ANN SALMON FNP (NPI 1134577463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689600322 NPI number — DIAGNOSTIC ASSOCIATES OF NORTH TEXAS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIAGNOSTIC ASSOCIATES OF NORTH TEXAS PA
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:
1689600322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7902 STONE RIVER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-7288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-377-2990
Provider Business Mailing Address Fax Number:
972-377-2551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7902 STONE RIVER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-7288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-377-2990
Provider Business Practice Location Address Fax Number:
972-377-2551
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SASTRY
Authorized Official First Name:
VIVEK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
972-377-2990

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 080125001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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