1912989534 NPI number — HEART INSTITUTE OF TULSA, INC.

Table of content: (NPI 1912989534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912989534 NPI number — HEART INSTITUTE OF TULSA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART INSTITUTE OF TULSA, 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:
DIAGNOSTIC HEALTH SERVICES
Provider Other Organization Name Type Code:
3
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:
1912989534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5055 KELLER SPRINGS RD
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75001-5997
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-242-8500
Provider Business Mailing Address Fax Number:
214-242-8600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6972 E 38TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74145-3246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-664-7500
Provider Business Practice Location Address Fax Number:
918-664-4850
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
214-242-8500

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0208X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 100740050B , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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