1942959176 NPI number — SUVEKCHYA SUBEDI, PLLC

Table of content: (NPI 1942959176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942959176 NPI number — SUVEKCHYA SUBEDI, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUVEKCHYA SUBEDI, 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:
CONNECT, HEAL AND EMPOWER PSYCHIATRY
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:
1942959176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2629 WALKER CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76118-2027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2629 WALKER CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76118-2027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-962-9063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2022

Additional Information

Authorized Official

Authorized Official Last Name:
SOJOURNER
Authorized Official First Name:
HILARY
Authorized Official Middle Name:
HOLLINGSWORTH
Authorized Official Title or Position:
CREDENTIALING CONSULTANT
Authorized Official Telephone Number:
817-721-2372

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com