1164797791 NPI number — ACUTE KIDS URGENT CARE OF MEDICAL CITY CHILDREN'S HOSPITAL PLLC

Table of content: (NPI 1164797791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164797791 NPI number — ACUTE KIDS URGENT CARE OF MEDICAL CITY CHILDREN'S HOSPITAL PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUTE KIDS URGENT CARE OF MEDICAL CITY CHILDREN'S HOSPITAL PLLC
Provider Last Name:
Provider First Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1164797791
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 742091
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-2091
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-745-7500
Provider Business Mailing Address Fax Number:
972-745-4336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3305 DALLAS PKWY
Provider Second Line Business Practice Location Address:
SUITE 345
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-300-4200
Provider Business Practice Location Address Fax Number:
972-300-4201
Provider Enumeration Date:
03/15/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MCKINNEY
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
AVP REVENUE CYCLE URGENT CARE
Authorized Official Telephone Number:
972-906-8107

Provider Taxonomy Codes

  • Taxonomy code: 2080A0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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