Basic Information
| Provider Information | |||||||||
| NPI: | 1104976703 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 E BORDER ST | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760107445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143457260 | ||||||||
| FaxNumber: | 6822364620 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 ED HALL DRIVE | ||||||||
| Address2: | |||||||||
| City: | KAUFMAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751421861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729327255 | ||||||||
| FaxNumber: | 9729325425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | CRAFT | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | GROUP FINANCE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2143455634 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 11/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 000303 | TX | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 094140301 | 05 | TX | MEDICAID |