1891799599 NPI number — MRS. CATHERINE CARRIZALES-PINTOR FNP

Table of content: MRS. CATHERINE CARRIZALES-PINTOR FNP (NPI 1891799599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891799599 NPI number — MRS. CATHERINE CARRIZALES-PINTOR FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARRIZALES-PINTOR
Provider First Name:
CATHERINE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
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:
1891799599
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 E UNIVERSITY AVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78626-6814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-868-1124
Provider Business Mailing Address Fax Number:
512-869-2940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2423 WILLIAMS DR
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-800-5722
Provider Business Practice Location Address Fax Number:
512-930-7400
Provider Enumeration Date:
06/09/2005

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: 363LF0000X , with the licence number:  AP105281 , 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)

  • Identifier: 156061701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".