1265710594 NPI number — NORTHPOINT RADIATION CENTER GP LLC

Table of content: (NPI 1265710594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265710594 NPI number — NORTHPOINT RADIATION CENTER GP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHPOINT RADIATION CENTER GP LLC
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:
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:
1265710594
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 678083
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:
75267-8083
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-583-0205
Provider Business Mailing Address Fax Number:
512-583-2001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7718 LOUIS PASTEUR CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-3442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-477-9060
Provider Business Practice Location Address Fax Number:
210-477-9065
Provider Enumeration Date:
08/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DICKEY
Authorized Official First Name:
DAVE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
972-573-4611

Provider Taxonomy Codes

  • Taxonomy code: 261QX0203X , with the licence number:  R06604 , 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)





Copyright © 2007-2025 www.npivalidator.com