1518173285 NPI number — D&S RESIDENTIAL SERVICES, LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518173285 NPI number — D&S RESIDENTIAL SERVICES, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D&S RESIDENTIAL SERVICES, LP
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:
1518173285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8911 NORTH CAPITAL OF TEXAS HIGHWAY
Provider Second Line Business Mailing Address:
BUILDING 1, SUITE 1300
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78759-7203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-327-2325
Provider Business Mailing Address Fax Number:
512-263-2161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2402 WOODBINE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLADWATER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-845-7923
Provider Business Practice Location Address Fax Number:
903-984-3355
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COHEN
Authorized Official First Name:
BRETT
Authorized Official Middle Name:
IAN
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
800-388-5150

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X , with the licence number:  000729302 , 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: 000729302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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