1902857766 NPI number — COLUMBIA MEDICAL CENTER OF LAS COLINAS INC

Table of content: (NPI 1902857766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902857766 NPI number — COLUMBIA MEDICAL CENTER OF LAS COLINAS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBIA MEDICAL CENTER OF LAS COLINAS INC
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:
MEDICAL CITY LAS COLINAS
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:
1902857766
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6800 N MACARTHUR BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75039-2422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-969-2084
Provider Business Mailing Address Fax Number:
972-969-2080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6800 N MACARTHUR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75039-2422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-969-2084
Provider Business Practice Location Address Fax Number:
972-969-2080
Provider Enumeration Date:
05/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TROCHESSET
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
972-969-2084

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01600881 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2564354 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4500822 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 81658761 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 016115602 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 020979301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100506358 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200500490A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP33519 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1700614 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200023570A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 784753 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: HOS0822N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120387800 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165914800 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200003790A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 912568000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 146006105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300044511A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0940 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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