1629093117 NPI number — ADAPT OF TEXAS, INC.

Table of content: (NPI 1629093117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629093117 NPI number — ADAPT OF TEXAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAPT OF TEXAS, 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:
Provider Other Organization Name Type Code:
6
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:
1629093117
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
323 CONSORT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALLWIN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63011-4439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-315-0488
Provider Business Mailing Address Fax Number:
972-554-7102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 N. STEMMONS FREEWAY
Provider Second Line Business Practice Location Address:
SUITE 151
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75207-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-905-0595
Provider Business Practice Location Address Fax Number:
214-905-0979
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
877-315-0488

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 083397201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 126218 . This is a "NORTHSTAR PROVIDER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com