1811594690 NPI number — WILLIAM C HADEN MD PLLC

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 1811594690 NPI number — WILLIAM C HADEN MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM C HADEN MD 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:
1811594690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6331 MERCEDES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75214-3007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-799-4781
Provider Business Mailing Address Fax Number:
214-614-9184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3500 GASTON AVE
Provider Second Line Business Practice Location Address:
4TH FLOOR JONSSON BL
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75246-7524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-957-1067
Provider Business Practice Location Address Fax Number:
214-614-9184
Provider Enumeration Date:
10/05/2020

Additional Information

Authorized Official

Authorized Official Last Name:
HADEN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
214-799-4781

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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