1518043785 NPI number — MS. GAIL ARDMAN MSSW

Table of content: MS. GAIL ARDMAN MSSW (NPI 1518043785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518043785 NPI number — MS. GAIL ARDMAN MSSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARDMAN
Provider First Name:
GAIL
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518043785
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:
3220 PEBBLE BEACH DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMERS BRANCH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75234-2215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-406-0026
Provider Business Mailing Address Fax Number:
972-620-9904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3220 PEBBLE BEACH DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMERS BRANCH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75234-2215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-406-0026
Provider Business Practice Location Address Fax Number:
972-620-9904
Provider Enumeration Date:
10/31/2006

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: 101YA0400X , with the licence number:  LCDC 2828 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: 16302 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT 002871 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0075JN . This is a "BCBS PIN #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 489498 . This is a "VALUE OPTIONS PIN #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7082377 . This is a "AETNA PIN #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".