1942403951 NPI number — DOC MANAGEMENT CORP

Table of content: (NPI 1942403951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942403951 NPI number — DOC MANAGEMENT CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOC MANAGEMENT CORP
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:
ADAMS DENTAL CARE
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:
1942403951
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
610 MELTON ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
MAGNOLIA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77354-2365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-356-8014
Provider Business Mailing Address Fax Number:
281-356-8714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
610 MELTON ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
MAGNOLIA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77354-2365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-356-8014
Provider Business Practice Location Address Fax Number:
281-356-8714
Provider Enumeration Date:
06/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
281-446-5588

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  18850 , 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: 0012411 . This is a "FORTIS ASS EB" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1754228-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 255663 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 62722 . This is a "SAFEGUARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 996295 . This is a "COMPDENT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 221290 . This is a "CIGNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 63726 . This is a "U. CONCORDIA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0005267 . This is a "MANAGED DENTAL GUARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1853 . This is a "PRUDENTIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5948 . This is a "NAT PACIFIC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com