Provider Demographics
NPI:1952355919
Name:COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP
Entity Type:Organization
Organization Name:COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP
Other - Org Name:MEDICAL CITY DENTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PROCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-384-3206
Mailing Address - Street 1:2000 S FM 51
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3702
Mailing Address - Country:US
Mailing Address - Phone:940-627-5921
Mailing Address - Fax:
Practice Address - Street 1:2000 S FM 51
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3702
Practice Address - Country:US
Practice Address - Phone:940-627-5921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========006OtherTRICARE REHAB
45T634Medicare Oscar/Certification