1801075635 NPI number — ALVIN W. LARKINS, M.D., P.A.

Table of content: (NPI 1801075635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801075635 NPI number — ALVIN W. LARKINS, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALVIN W. LARKINS, 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:
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:
1801075635
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
755 N 11TH ST
Provider Second Line Business Mailing Address:
SUITE P2300
Provider Business Mailing Address City Name:
BEAUMONT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77702-1500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-892-4100
Provider Business Mailing Address Fax Number:
409-892-4108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
755 N 11TH ST
Provider Second Line Business Practice Location Address:
SUITE P2300
Provider Business Practice Location Address City Name:
BEAUMONT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77702-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-892-4100
Provider Business Practice Location Address Fax Number:
409-892-4108
Provider Enumeration Date:
10/29/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LARKINS
Authorized Official First Name:
ALVIN
Authorized Official Middle Name:
WAYNE
Authorized Official Title or Position:
OWNER, PRESIDENT
Authorized Official Telephone Number:
409-892-4100

Provider Taxonomy Codes

  • Taxonomy code: 207XS0117X , with the licence number:  D9212 , 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)