1760668552 NPI number — O & P DESIGNS, INC.

Table of content: (NPI 1760668552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760668552 NPI number — O & P DESIGNS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
O & P DESIGNS, 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:
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:
1760668552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
618 CLARA BARTON BLVD
Provider Second Line Business Mailing Address:
SUITE 7
Provider Business Mailing Address City Name:
GARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75042-5750
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-487-1951
Provider Business Mailing Address Fax Number:
972-487-1891

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10525 NEWKIRK ST
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75220-2330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-572-1241
Provider Business Practice Location Address Fax Number:
214-572-1246
Provider Enumeration Date:
01/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DONAHUE
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
V
Authorized Official Title or Position:
VP, COO
Authorized Official Telephone Number:
972-487-1951

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , with the licence number:  101105 , 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: 503907 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 146681501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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