Provider Demographics
NPI:1225399934
Name:PLANNED PARENTHOOD OF GREATER TEXAS FAMILY PLANNING SERVICES
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF GREATER TEXAS FAMILY PLANNING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE MGMT.
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-254-3016
Mailing Address - Street 1:7424 GREENVILLE AVENUE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-363-2004
Mailing Address - Fax:214-254-3092
Practice Address - Street 1:6464 JOHN RYAN DRIVE
Practice Address - Street 2:STE. B
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132
Practice Address - Country:US
Practice Address - Phone:817-276-8083
Practice Address - Fax:817-346-7703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANNED PARENTHOOD OF GREATER TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-30
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136481222Medicaid