Provider Demographics
NPI:1134395874
Name:CROSS HYPERBARIC OF TEXAS P L L C
Entity type:Organization
Organization Name:CROSS HYPERBARIC OF TEXAS P L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-850-1780
Mailing Address - Street 1:5197 BRANDYWINE LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2243
Mailing Address - Country:US
Mailing Address - Phone:214-850-1780
Mailing Address - Fax:469-579-4094
Practice Address - Street 1:4351 BOOTH CALLOWAY RD
Practice Address - Street 2:NORTH HILLS HOSPITAL, SUITE 410
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7378
Practice Address - Country:US
Practice Address - Phone:214-850-1780
Practice Address - Fax:469-579-4094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5949207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A3284Medicare PIN