Provider Demographics
NPI:1215989975
Name:COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP
Entity type:Organization
Organization Name:COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-384-3206
Mailing Address - Street 1:3535 S I-35 E
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6850
Mailing Address - Country:US
Mailing Address - Phone:940-384-3535
Mailing Address - Fax:940-382-4864
Practice Address - Street 1:3535 S I-35 E
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6850
Practice Address - Country:US
Practice Address - Phone:469-420-7602
Practice Address - Fax:940-382-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111905904Medicaid