1538207642 NPI number — CITY OF FRISCO

Table of content: (NPI 1538207642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538207642 NPI number — CITY OF FRISCO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF FRISCO
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:
1538207642
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 49097
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77210-9097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-978-6283
Provider Business Mailing Address Fax Number:
972-292-6319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8601 GARY BURNS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-2594
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-292-6300
Provider Business Practice Location Address Fax Number:
972-292-6319
Provider Enumeration Date:
02/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DEPUTY CITY MANAGER
Authorized Official Telephone Number:
972-292-6300

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  43009 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 043009 , 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: P00097954 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000082001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 505775 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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