1629433164 NPI number — HI-ENERGY WEIGHT LOSS CENTERS OF TEXAS, INC.

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 1629433164 NPI number — HI-ENERGY WEIGHT LOSS CENTERS OF TEXAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HI-ENERGY WEIGHT LOSS CENTERS OF TEXAS, INC.
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:
1629433164
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2050 SHADY OAKS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHLAKE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76092-3510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-271-4154
Provider Business Mailing Address Fax Number:
817-796-1595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1921 PRESTON RD
Provider Second Line Business Practice Location Address:
#2008
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-5124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-381-9300
Provider Business Practice Location Address Fax Number:
972-381-9301
Provider Enumeration Date:
12/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
OREN
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
JOEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
817-271-4154

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  E4781 , 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: 1043277221 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1215094933 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1871868232 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1558612325 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1376654988 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1740308923 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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