1659352987 NPI number — USMD HOSPITAL AT ARLINGTON, L.P.

Table of content: (NPI 1659352987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659352987 NPI number — USMD HOSPITAL AT ARLINGTON, L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
USMD HOSPITAL AT ARLINGTON, L.P.
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:
1659352987
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 W INTERSTATE 20
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76017-5851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-472-3400
Provider Business Mailing Address Fax Number:
817-472-3536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 INTERSTATE 20 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76017-5851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-472-3400
Provider Business Practice Location Address Fax Number:
817-472-3710
Provider Enumeration Date:
11/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
URSIN
Authorized Official First Name:
RONNIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
817-472-3535

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  007990 , 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: 193276 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7364801 . This is a "CIGNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0101690002 . This is a "PACIFICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7550393 . This is a "AETNA PPO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 162965101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 162965102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH1034 . This is a "BLUE CROSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 201062800 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1707287 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3302912 . This is a "AETNA HMO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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