1619028628 NPI number — WILLIAMS AND SIVIE DDS LLP

Table of content: (NPI 1619028628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619028628 NPI number — WILLIAMS AND SIVIE DDS LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAMS AND SIVIE DDS LLP
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:
1619028628
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5800 COIT RD.
Provider Second Line Business Mailing Address:
SUITE 800
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75023-5944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-596-9697
Provider Business Mailing Address Fax Number:
972-867-4796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5800 COIT RD.
Provider Second Line Business Practice Location Address:
SUITE 800
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75023-5944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-596-9697
Provider Business Practice Location Address Fax Number:
972-867-4796
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HODGES
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
W
Authorized Official Title or Position:
TREATMENT COORDINATOR
Authorized Official Telephone Number:
972-596-9697

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , 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: 85D561 . This is a "FEDERAL ID# NICOLE SIVIE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 85D562 . This is a "FEDERAL ID# BRAD WILLIAMS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 902701 . This is a "UNITED CONCORDIA ID#SIVIE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 173259 . This is a "UNITED CONCORDIA#WILLIAMS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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