1598857658 NPI number — PULMO-GUARD HEALTH CARE L.L.C.

Table of content: (NPI 1598857658)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598857658 NPI number — PULMO-GUARD HEALTH CARE L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PULMO-GUARD HEALTH CARE L.L.C.
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:
1598857658
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2629 N STEMMONS FREEWAY
Provider Second Line Business Mailing Address:
#218
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75207-2100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-827-8803
Provider Business Mailing Address Fax Number:
214-827-8813

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2629 N STEMMONS FREEWAY
Provider Second Line Business Practice Location Address:
#218
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75207-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-827-8803
Provider Business Practice Location Address Fax Number:
214-827-8813
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
VINOD
Authorized Official Middle Name:
C
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
713-961-4151

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0056572 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BX2000X , with the licence number: 0056572 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 09971502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 519577 . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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