1003206699 NPI number — TODD D. BUCHANAN, M.D., P.A.

Table of content: (NPI 1003206699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003206699 NPI number — TODD D. BUCHANAN, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TODD D. BUCHANAN, 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:
DRIPPING SPRINGS FAMILY CLINIC
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:
1003206699
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1183
Provider Second Line Business Mailing Address:
104 MERCER
Provider Business Mailing Address City Name:
DRIPPING SPRINGS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78620-1183
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-858-4166
Provider Business Mailing Address Fax Number:
512-858-4196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 W MERCER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DRIPPING SPRINGS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78620-5248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-858-4166
Provider Business Practice Location Address Fax Number:
512-858-4196
Provider Enumeration Date:
02/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BUCHANAN
Authorized Official First Name:
TODD
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
512-858-4166

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  235901 , 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)





Copyright © 2007-2024 www.npivalidator.com