COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP

Provider Demographics

• NPI: 1255384533
• Name: COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP
• Entity type: Organization
• Organization Name: COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: RHONDA
• Authorized Official - Last Name: BOOTS
• Authorized Official - Phone: 469-370-2703
• Mailing Address - Street 1: 500 W MAIN ST
• Mailing Address - City: LEWISVILLE
• Mailing Address - State: TX
• Mailing Address - Zip Code: 75057-3629
• Mailing Address - Country: US
• Mailing Address - Phone: 972-420-1000
• Mailing Address - Fax: 972-420-1073
• Practice Address - Street 1: 500 W MAIN ST
• Practice Address - City: LEWISVILLE
• Practice Address - State: TX
• Practice Address - Zip Code: 75057-3629
• Practice Address - Country: US
• Practice Address - Phone: 972-420-1000
• Practice Address - Fax: 972-420-1073
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-18
• Last Update Date: 2025-06-04

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	282N00000X	Hospitals	General Acute Care Hospital

Provider Identifiers

State	Identifier ID	ID Type	Issuer
VT	0450669	Medicaid
IA	0548578	Medicaid
WA	3024924	Medicaid
MN	351303300	Medicaid
KS	200002000A	Medicaid
WI	82274500	Medicaid
VA	010136423	Medicaid
TX	094192402	Medicaid
SC	11117A	Medicaid
NC	4500669	Medicaid
LA	1764663	Medicaid
MO	015783905	Medicaid
MS	07051779	Medicaid
IN	200390940A	Medicaid
ID	806722000	Medicaid
FL	910927700	Medicaid
AR	146098105	Medicaid
NM	A7174	Medicaid
CA	XHSP30118	Medicaid
GA	000593975X	Medicaid
OK	100689660A	Medicaid
	166018400	Other	DEPT OF LABOR
NJ	8764204	Medicaid
	HH0725	Other	BLUE CROSS
NY	=========	Medicaid
IL	=========001	Medicaid
	=========001	Other	TRICARE
GA	000593975X	Medicaid
KS	200002000A	Medicaid
	450669	Medicare Oscar/Certification