1437278041 NPI number — ROBERT DANIEL GATES

Table of content: (NPI 1437278041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437278041 NPI number — ROBERT DANIEL GATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT DANIEL GATES
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:
1437278041
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6966 S UTICA AVE
Provider Second Line Business Mailing Address:
STE 225
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74136-3903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-492-6333
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2605 FOXBORO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75070-4329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-668-7460
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GATES
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
DANIEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
972-668-7460

Provider Taxonomy Codes

  • Taxonomy code: 246ZS0410X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 471454 . This is a "THE JOINT COMMISSION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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