1447375704 NPI number — NORTH TEXAS ORTHODONTIC ASSOCIATES, P.A.

Table of content: AMANDA BETH EMERY QMHA (NPI 1497875678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447375704 NPI number — NORTH TEXAS ORTHODONTIC ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH TEXAS ORTHODONTIC ASSOCIATES, P.A.
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:
1447375704
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 N ALMA DR
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
ALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75013-3337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-727-7486
Provider Business Mailing Address Fax Number:
972-727-0970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 N ALMA DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
ALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75013-3337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-727-7486
Provider Business Practice Location Address Fax Number:
972-727-0970
Provider Enumeration Date:
03/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BEATY
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
972-727-7486

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  18244 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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