1093199523 NPI number — LACTATION SPECIALIST OF HOUSTON, LLC

Table of content: JOHN M. RITTER DDS (NPI 1942399175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093199523 NPI number — LACTATION SPECIALIST OF HOUSTON, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LACTATION SPECIALIST OF HOUSTON, LLC
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:
1093199523
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22203 SPRING CROSSING DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77373-5068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-938-0083
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22203 SPRING CROSSING DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77373-5068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-938-0083
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCQUEEN
Authorized Official First Name:
APRILLE
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER / FOUNDER
Authorized Official Telephone Number:
832-938-0083

Provider Taxonomy Codes

  • Taxonomy code: 174N00000X , with the licence number:  11116611 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174N00000X , with the licence number: 11027221 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11116611 . This is a "LACTATION CONSULTANT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 11027221 . This is a "LACTATION CONSULTANT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".