Basic Information
| Provider Information | |||||||||
| NPI: | 1255724639 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COLUMBIA NORTH HILLS HOSPITAL SUBSIDIARY LP | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | MEDICAL CITY NORTH HILLS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 BOOTH CALLOWAY RD | ||||||||
| Address2: | |||||||||
| City: | NORTH RICHLAND HILLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761807371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172551000 | ||||||||
| FaxNumber: | 8172844815 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 BOOTH CALLOWAY RD | ||||||||
| Address2: | |||||||||
| City: | NORTH RICHLAND HILLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761807371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172551000 | ||||||||
| FaxNumber: | 8172844815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2015 | ||||||||
| LastUpdateDate: | 11/15/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GALT | ||||||||
| AuthorizedOfficialFirstName: | NICK | ||||||||
| AuthorizedOfficialMiddleName: | W. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8172551106 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COLUMBIA NORTH HILLS HOSPITAL SUBSIDIARY LP | ||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | Y | Hospital Units | Psychiatric Unit |
No ID Information.