1780743922 NPI number — LAURA TORRES BARRE M D P A

Table of content: GEORGETTE NAMMOUR (NPI 1619460706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780743922 NPI number — LAURA TORRES BARRE M D P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAURA TORRES BARRE M D P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELITE ORTHOPEDICS/SPORTS MEDICINE
Provider Other Organization Name Type Code:
3
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:
1780743922
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8603 BROADWAY ST
Provider Second Line Business Mailing Address:
SUITE #101
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77584-8171
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-997-3717
Provider Business Mailing Address Fax Number:
281-997-3817

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8603 BROADWAY ST
Provider Second Line Business Practice Location Address:
SUITE #101
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-8171
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-997-3717
Provider Business Practice Location Address Fax Number:
281-997-3817
Provider Enumeration Date:
12/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES-BARRE
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-997-3717

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  L6201 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: L6201 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 86NB . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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