1508563438 NPI number — CASTLE HILLS ER PHYSICIANS - CARROLLTON PLLC

Table of content: (NPI 1508563438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508563438 NPI number — CASTLE HILLS ER PHYSICIANS - CARROLLTON PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASTLE HILLS ER PHYSICIANS - CARROLLTON 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:
1508563438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2586
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-2856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-482-0861
Provider Business Mailing Address Fax Number:
469-273-1720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4228 N JOSEY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75010-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-482-0861
Provider Business Practice Location Address Fax Number:
469-273-1720
Provider Enumeration Date:
02/10/2023

Additional Information

Authorized Official

Authorized Official Last Name:
FARHAT
Authorized Official First Name:
NIAZ
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
903-570-8709

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; 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