Provider Demographics
NPI:1902857766
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:2006-05-15
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01600881Medicaid
OH2564354Medicaid
NC4500822Medicaid
CO81658761Medicaid
MO016115602Medicaid
TX020979301Medicaid
NV100506358Medicaid
IN200500490AMedicaid
CAXHSP33519Medicaid
LA1700614Medicaid
OK200023570AMedicaid
AZ784753Medicaid
ALHOS0822NMedicaid
WY120387800Medicaid
165914800OtherDEPT OF LABOR
KS200003790AMedicaid
FL912568000Medicaid
AR146006105Medicaid
GA300044511AMedicaid
HH0940OtherBLUE CROSS
CT003122265Medicaid
WA3024163Medicaid
MD406704500Medicaid
MN363599600Medicaid
WA3024163Medicaid
AZ784753Medicaid
AZ784753Medicaid