1750402699 NPI number — HIGH PLAINS EAR NOSE & THROAT ASSOCIATES PLLC

Table of content: (NPI 1750402699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750402699 NPI number — HIGH PLAINS EAR NOSE & THROAT ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGH PLAINS EAR NOSE & THROAT ASSOCIATES PLLC
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:
1750402699
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5211 W 9TH
Provider Second Line Business Mailing Address:
#104
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79106-4149
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-355-8293
Provider Business Mailing Address Fax Number:
806-355-7298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5211 W 9TH
Provider Second Line Business Practice Location Address:
#104
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79106-4149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-355-8293
Provider Business Practice Location Address Fax Number:
806-355-7298
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KENNEDY
Authorized Official First Name:
KYLE
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
806-355-8293

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  K0325 , 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: P00098823 . This is a "RAILROAD MEDICARE UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0031LC . This is a "BCBS GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8M1200 . This is a "BCBS UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00307W . This is a "MEDICARE GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: DB3415 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com