1710011382 NPI number — TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE

Table of content: (NPI 1710011382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710011382 NPI number — TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE
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:
1710011382
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 EAST BORDER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-570-8500
Provider Business Mailing Address Fax Number:
817-570-8199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 N. BELKNAP STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STEPHENVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76401-3415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-965-1556
Provider Business Practice Location Address Fax Number:
254-965-1591
Provider Enumeration Date:
03/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CROSS
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
254-965-1556

Provider Taxonomy Codes

  • Taxonomy code: 281P00000X , with the licence number:  000256 , 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: 025238901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".