1043229339 NPI number — DR. MARTHA ALICIA ALANIZ LPC

Table of content: DR. MARTHA ALICIA ALANIZ LPC (NPI 1043229339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043229339 NPI number — DR. MARTHA ALICIA ALANIZ LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALANIZ
Provider First Name:
MARTHA
Provider Middle Name:
ALICIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALANIZ
Provider Other First Name:
MARTHA
Provider Other Middle Name:
ALICIA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043229339
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17503 LA CANTERA PKWY
Provider Second Line Business Mailing Address:
SUITE 104, BOX 509
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78257-8207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-266-2808
Provider Business Mailing Address Fax Number:
210-614-4991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17503 LA CANTERA PKWY
Provider Second Line Business Practice Location Address:
SUITE 104, BOX 509
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78257-8207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-4990
Provider Business Practice Location Address Fax Number:
210-614-4991
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  19050 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 167167901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com