1437171568 NPI number — METHODIST CHILDREN'S HOSPITAL

Table of content: (NPI 1437171568)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437171568 NPI number — METHODIST CHILDREN'S HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METHODIST CHILDREN'S HOSPITAL
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:
1437171568
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 677044
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:
75267-7044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-725-6967
Provider Business Mailing Address Fax Number:
806-725-5356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4015 22ND PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79410-1203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-725-1011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
W
Authorized Official Title or Position:
ASSISTANT SECRETARY FOR ENROLLMENT
Authorized Official Telephone Number:
425-951-7477

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0203X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 103188100 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1273195-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: A9467 . This is a "ACUTE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 1273195-04 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 133478106 . This is a "CSCHN/ACUTE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 103171100 . This is a "FIRSTCARE COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201075601 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH1177 . This is a "BLUE CROSS TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 127319503 . This is a "CSCHN/ DAY SURGERY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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