1447756580 NPI number — PRECISE TELEHEALTH OF TEXAS PLLC

Table of content: (NPI 1447756580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447756580 NPI number — PRECISE TELEHEALTH OF TEXAS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRECISE TELEHEALTH OF TEXAS PLLC
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:
1447756580
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 W PADONIA RD STE C241
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TIMONIUM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-2237
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-524-9871
Provider Business Mailing Address Fax Number:
844-828-6164

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3705 DEL PAYNE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PFLUGERVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78660-4535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-524-9871
Provider Business Practice Location Address Fax Number:
844-828-6164
Provider Enumeration Date:
04/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
TREMBLAY
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF TECHNICAL OFFICER
Authorized Official Telephone Number:
737-402-7045

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  TM0677 , 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)





Copyright © 2007-2025 www.npivalidator.com