Provider Demographics
NPI:1548213739
Name:COLUMBIA MEDICAL CENTER OF LAS COLINAS INC
Entity Type:Organization
Organization Name:COLUMBIA MEDICAL CENTER OF LAS COLINAS INC
Other - Org Name:MEDICAL CITY LAS COLINAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TROCHESSET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-969-2084
Mailing Address - Street 1:6800 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2422
Mailing Address - Country:US
Mailing Address - Phone:972-969-2084
Mailing Address - Fax:972-969-2080
Practice Address - Street 1:6800 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2422
Practice Address - Country:US
Practice Address - Phone:972-969-2084
Practice Address - Fax:972-969-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX022547601Medicaid