1942443924 NPI number — UNLIMITED CARE OF NORTH TEXAS, INC.

Table of content: KENNEDY CHRISTINE NIES DO (NPI 1700527603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942443924 NPI number — UNLIMITED CARE OF NORTH TEXAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNLIMITED CARE OF NORTH TEXAS, 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:
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:
1942443924
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1147
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PILOT POINT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76258-1147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-390-0493
Provider Business Mailing Address Fax Number:
940-440-9090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
608 N BELL AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76209-4207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-390-0493
Provider Business Practice Location Address Fax Number:
940-440-9090
Provider Enumeration Date:
04/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DEGRAFFENREID
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
LAVONNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
940-390-0493

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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