1093786204 NPI number — NHCI OF HILLSBORO INC

Table of content: (NPI 1093786204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093786204 NPI number — NHCI OF HILLSBORO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NHCI OF HILLSBORO 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:
1093786204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 CIRCLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76645-2670
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-580-8951
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 CIRCLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76645-2670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-580-8500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPEIGHT
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
469-297-5336

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  000383 , 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: 133252005 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0490079 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0013207 . This is a "HARRIS METHODIST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 104022100 . This is a "FIRSTCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 323527500450192 . This is a "LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100701440A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4291505 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: H04501922 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0140 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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