1477583334 NPI number — NEW MEDICAL HORIZONS II, LTD.

Table of content: (NPI 1477583334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477583334 NPI number — NEW MEDICAL HORIZONS II, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW MEDICAL HORIZONS II, LTD.
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:
1477583334
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 849762
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:
75284-9762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-949-3615
Provider Business Mailing Address Fax Number:
281-890-5341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10655 STEEPLETOP DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77065-4222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-890-4285
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARMIN
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
VP OF GOVT PROGRAMS, TENET
Authorized Official Telephone Number:
818-436-2267

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 000606 , 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: 742054101 . This is a "FORTIS JOHN ALDEN LIFE IN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112718502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 603334 . This is a "AETNA US HEALTHCARE (NATI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 742054101 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9540 . This is a "COVENTRY HEALTH CARE LOUI" identifier . This identifiers is of the category "OTHER".
  • Identifier: HH0768 . This is a "BCBS OF TEXAS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112718503 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1760048 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 74-2054101 . This is a "PPONEXT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 450716B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".




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