1760743462 NPI number — PLANNED PARENTHOOD OF GREATER TEXAS INC, - NORTHEAST

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 1760743462 NPI number — PLANNED PARENTHOOD OF GREATER TEXAS INC, - NORTHEAST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF GREATER TEXAS INC, - NORTHEAST
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:
1760743462
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7424 GREENVILLE AVE
Provider Second Line Business Mailing Address:
#206
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-4552
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-363-2004
Provider Business Mailing Address Fax Number:
214-696-2091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2824 CENTRAL DR
Provider Second Line Business Practice Location Address:
STE 332
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76021-7819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-545-0077
Provider Business Practice Location Address Fax Number:
817-685-7952
Provider Enumeration Date:
05/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WATSON
Authorized Official First Name:
BETH
Authorized Official Middle Name:
Authorized Official Title or Position:
VP HEALTH SERVICES
Authorized Official Telephone Number:
214-363-2004

Provider Taxonomy Codes

  • Taxonomy code: 261QF0050X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 136481221 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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