1073537262 NPI number — MR. MIGUEL ANGEL ANGLADA JR. LCSW

Table of content: MR. MIGUEL ANGEL ANGLADA JR. LCSW (NPI 1073537262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073537262 NPI number — MR. MIGUEL ANGEL ANGLADA JR. LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANGLADA
Provider First Name:
MIGUEL
Provider Middle Name:
ANGEL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANGLADA
Provider Other First Name:
MIGUEL
Provider Other Middle Name:
ANGEL
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
JR.
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1073537262
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10223 GARDEN CROSSING LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSOURI CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77459-6478
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-778-8631
Provider Business Mailing Address Fax Number:
281-778-8632

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6701 HIGHWAY 6 STE 140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSOURI CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77459-4371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-483-5806
Provider Business Practice Location Address Fax Number:
281-778-8632
Provider Enumeration Date:
07/27/2006

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: 1041C0700X , with the licence number:  22858 , 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)