1912435348 NPI number — CODE 3 EMERGENCY PARTNERS AT DENTON, LLC

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 1912435348 NPI number — CODE 3 EMERGENCY PARTNERS AT DENTON, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CODE 3 EMERGENCY PARTNERS AT DENTON, 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:
CODE 3 ER AT DENTON
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:
1912435348
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5300 TOWN AND COUNTRY BLVD STE 260
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:
75034-6913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-208-5297
Provider Business Mailing Address Fax Number:
214-260-0707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3111 TEASLEY LANE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76205-8024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-514-8120
Provider Business Practice Location Address Fax Number:
940-514-8123
Provider Enumeration Date:
05/30/2017

Additional Information

Authorized Official

Authorized Official Last Name:
DE MOOR
Authorized Official First Name:
CARRIE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
469-320-9820

Provider Taxonomy Codes

  • Taxonomy code: 261QE0002X , with the licence number:  160343 , 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)





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