1346554284 NPI number — TRAVELING PHYSICIANS NETWORK

Table of content: (NPI 1346554284)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346554284 NPI number — TRAVELING PHYSICIANS NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRAVELING PHYSICIANS NETWORK
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:
1346554284
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2831 ELDORADO PKWY STE 103-303
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-7438
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-619-3080
Provider Business Mailing Address Fax Number:
469-252-3509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1505 HARROUN AVE
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75069-3432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-619-3080
Provider Business Practice Location Address Fax Number:
469-252-3509
Provider Enumeration Date:
08/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
VICKI
Authorized Official Middle Name:
B
Authorized Official Title or Position:
MEDICAL DOCTOR
Authorized Official Telephone Number:
469-619-3080

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X ; 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