1790771707 NPI number — MRS. KAREN THOMAS MCBEE

Table of content: MRS. KAREN THOMAS MCBEE (NPI 1790771707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790771707 NPI number — MRS. KAREN THOMAS MCBEE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCBEE
Provider First Name:
KAREN
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMAS
Provider Other First Name:
KAREN
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1790771707
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5317 BAROUCHE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75023-5645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-867-2469
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 HIGHLANDER BLVD
Provider Second Line Business Practice Location Address:
STE. 415
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76015-4330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-516-8811
Provider Business Practice Location Address Fax Number:
817-516-8444
Provider Enumeration Date:
09/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  F4597 , 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: POOOSG 568 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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