1861776015 NPI number — NORTH TEXAS INPATIENT PHYSICIANS, PLLC

Table of content: (NPI 1861776015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861776015 NPI number — NORTH TEXAS INPATIENT PHYSICIANS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH TEXAS INPATIENT PHYSICIANS, 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:
1861776015
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O.BOX 94048
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHLAKE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-437-0500
Provider Business Mailing Address Fax Number:
972-559-3634

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3535 I35
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-437-0500
Provider Business Practice Location Address Fax Number:
972-559-3634
Provider Enumeration Date:
10/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MAHAN
Authorized Official First Name:
KERRY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
214-437-5000

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  M0476 , 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)





Copyright © 2007-2025 www.npivalidator.com