1962833228 NPI number — COOK CHILDREN'S MEDICAL CENTER

Table of content: STEVEN EDWARD HOLROYD M. D. (NPI 1871557942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962833228 NPI number — COOK CHILDREN'S MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COOK CHILDREN'S MEDICAL CENTER
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:
6
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:
1962833228
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 99213
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76199-0213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
682-885-1860
Provider Business Mailing Address Fax Number:
682-885-1396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 MATLOCK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANSFIELD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76063-9174
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-347-8400
Provider Business Practice Location Address Fax Number:
681-347-8495
Provider Enumeration Date:
12/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RHOADES
Authorized Official First Name:
CORY
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
682-885-4480

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  000332 , 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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