1144438136 NPI number — DR. CAROLINE HELLIN COOMBS-SKILES MD

Table of content: DR. CAROLINE HELLIN COOMBS-SKILES MD (NPI 1144438136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144438136 NPI number — DR. CAROLINE HELLIN COOMBS-SKILES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOMBS-SKILES
Provider First Name:
CAROLINE
Provider Middle Name:
HELLIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1144438136
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 911230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75391-1230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-997-8000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1015 E 32ND ST STE 306
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78705-2701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-294-2180
Provider Business Practice Location Address Fax Number:
512-822-7640
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  N4360 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086X0206X , with the licence number: N4360 , 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: 220102206 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220102205 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220102202 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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