1841611126 NPI number — COMMON SENSE CARE LLC

Table of content: (NPI 1841611126)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841611126 NPI number — COMMON SENSE CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMON SENSE CARE LLC
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:
CEDAR PARK EMERGENCY CENTER
Provider Other Organization Name Type Code:
3
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:
1841611126
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1464 E WHITESTONE BLVD STE 1100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR PARK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78613-9058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
737-787-7809
Provider Business Mailing Address Fax Number:
512-502-3428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3620 E WHITESTONE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR PARK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78613-7441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-761-0355
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAMPBELL
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PATIENT ADMISSIONS
Authorized Official Telephone Number:
512-948-1752

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QE0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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