1639255474 NPI number — NETWORK PROVIDER ASSOCIATES

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 1639255474 NPI number — NETWORK PROVIDER ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NETWORK PROVIDER ASSOCIATES
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:
1639255474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17300 DALLAS PKWY
Provider Second Line Business Mailing Address:
STE 1070
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75248-1145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-755-0800
Provider Business Mailing Address Fax Number:
972-755-0890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9550 FOREST LN
Provider Second Line Business Practice Location Address:
SUITE 700
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75243-5905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-348-5505
Provider Business Practice Location Address Fax Number:
214-348-9363
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BALLARD
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
EVERETT
Authorized Official Title or Position:
CIO
Authorized Official Telephone Number:
972-755-0800

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  18458 , 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)





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