1033684352 NPI number — OPEN ARMS HEALTHCARE OF TEXAS INC.

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 1033684352 NPI number — OPEN ARMS HEALTHCARE OF TEXAS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN ARMS HEALTHCARE OF 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:
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:
1033684352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8150 SPRINGWOOD DR # 150B
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:
75063-5810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-396-7397
Provider Business Mailing Address Fax Number:
214-396-7397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1437 S. VALLEY MILLS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-221-1901
Provider Business Practice Location Address Fax Number:
254-221-1909
Provider Enumeration Date:
10/13/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CARRILLO
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
817-831-6500

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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