1700341872 NPI number — MID WEST HOSPITAL PHYSICIANS, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700341872 NPI number — MID WEST HOSPITAL PHYSICIANS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MID WEST HOSPITAL PHYSICIANS, 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:
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:
1700341872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3689
Provider Second Line Business Mailing Address:
DEPT 508
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-3310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-264-0330
Provider Business Mailing Address Fax Number:
866-270-0129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1808 SHERMAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47670-1043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-385-3401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
SHEETS
Authorized Official First Name:
HARRY
Authorized Official Middle Name:
KYLE
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
888-264-0330

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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