Basic Information
Provider Information
NPI: 1790301653
EntityType: 2
ReplacementNPI:  
OrganizationName: BAART COMMUNITY HEALTHCARE
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 1720 LAKEPOINTE DR STE 117
Address2:  
City: LEWISVILLE
State: TX
PostalCode: 750576425
CountryCode: US
TelephoneNumber: 2143793300
FaxNumber: 2148539018
Practice Location
Address1: 1720 LAKEPOINTE DR STE 117
Address2:  
City: LEWISVILLE
State: TX
PostalCode: 750576425
CountryCode: US
TelephoneNumber: 2143793300
FaxNumber: 2245502635
Other Information
ProviderEnumerationDate: 06/17/2020
LastUpdateDate: 01/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: D'ANDRIA
AuthorizedOfficialFirstName: GENCO
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 2143793300
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X  Y Ambulatory Health Care FacilitiesClinic/Center 

No ID Information.


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