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General NPI Number Information
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NPI Number | 1932084027
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Entity Type | Organization
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Legal Business Name | CORALVITA HOLDCO LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 401 W CAMPBELL RD STE 300
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City | RICHARDSON
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State | TX
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Zip | 75080-3416
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Country | US
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Telephone | 469-329-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 400 LAS COLINAS BLVD E
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City | IRVING
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State | TX
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Zip | 75039-5579
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Country | US
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Telephone | 972-567-4932
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANIS SABETI
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Credential |
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Telephone | 972-567-4932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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