1891793816 NPI number — CARL H BECHTEL D.C

Table of content: CARL H BECHTEL D.C (NPI 1891793816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891793816 NPI number — CARL H BECHTEL D.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BECHTEL
Provider First Name:
CARL
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C
Provider Gender Code:
M

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:
1891793816
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/17/2006
NPI Reactivation Date:
03/31/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 721
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEMAH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77565-0721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-344-4700
Provider Business Mailing Address Fax Number:
281-334-4755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2129 FENWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEMAH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77565-2117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-344-4700
Provider Business Practice Location Address Fax Number:
281-334-4755
Provider Enumeration Date:
07/13/2005

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: 111N00000X , with the licence number:  4198 , 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)