1033344262 NPI number — WALK THE TALK AMERICA

Table of content: (NPI 1033344262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033344262 NPI number — WALK THE TALK AMERICA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALK THE TALK AMERICA
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:
1033344262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 571950
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77257-1950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-706-6103
Provider Business Mailing Address Fax Number:
713-706-6301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5850 SAN FELIPE RD SUITE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77057-1950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-706-6103
Provider Business Practice Location Address Fax Number:
713-706-6301
Provider Enumeration Date:
05/18/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UKPE
Authorized Official First Name:
DORCAS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
713-706-6103

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  DT80092 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133VN1005X , with the licence number: DT80092 , 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)