1407169196 NPI number — AMH CATH LABS LLC

Table of content: (NPI 1407169196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407169196 NPI number — AMH CATH LABS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMH CATH LABS 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:
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:
1407169196
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 E BORDER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76010-7445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-345-7260
Provider Business Mailing Address Fax Number:
682-236-4620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
811 WRIGHT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-419-6704
Provider Business Practice Location Address Fax Number:
972-419-8118
Provider Enumeration Date:
07/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
EMERSON
Authorized Official First Name:
SHERRI
Authorized Official Middle Name:
Authorized Official Title or Position:
VP COO
Authorized Official Telephone Number:
817-960-3551

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  100073 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 100073 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 284300000X , 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: 100073 . This is a "TDHSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 282322102 . This is a "MEDICAID HASCO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 282322101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH035D . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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