Healthcare Provider Details

I. General information

NPI: 1073664116
Provider Name (Legal Business Name): PRESBYTERIAN HOSPITAL OF PLANO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 W PARKER RD
PLANO TX
75093-7939
US

IV. Provider business mailing address

PO BOX 910156
DALLAS TX
75391-0156
US

V. Phone/Fax

Practice location:
  • Phone: 972-981-8079
  • Fax: 972-981-8111
Mailing address:
  • Phone: 800-890-6034
  • Fax: 682-236-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number000664
License Number StateTX

VIII. Authorized Official

Name: JEFF MINCHER
Title or Position: SENIOR VP REVENUE CYCLE
Credential:
Phone: 682-236-3013