1952736803 NPI number — SOUTHWEST HYPERBARICS 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 1952736803 NPI number — SOUTHWEST HYPERBARICS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWEST HYPERBARICS 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:
1952736803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2711 SHADOW WOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76006-2727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-255-1170
Provider Business Mailing Address Fax Number:
817-255-1171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4351 BOOTH CALLOWAY RD
Provider Second Line Business Practice Location Address:
#410
Provider Business Practice Location Address City Name:
NORTH RICHLAND HILLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76180-7378
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-255-1170
Provider Business Practice Location Address Fax Number:
817-255-1171
Provider Enumeration Date:
09/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
817-255-1170

Provider Taxonomy Codes

  • Taxonomy code: 207PE0005X , with the licence number:  E8963 , 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)





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