1508897885 NPI number — PHILIP G BOHART LPC

Table of content: PHILIP G BOHART LPC (NPI 1508897885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508897885 NPI number — PHILIP G BOHART LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOHART
Provider First Name:
PHILIP
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
M

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:
1508897885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 537
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SULPHUR SPRINGS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75483-0537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-361-2100
Provider Business Mailing Address Fax Number:
214-361-2145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8390 LBJ FRWY
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75243-1288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-361-2100
Provider Business Practice Location Address Fax Number:
214-361-2145
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  15980 , 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