1114534609 NPI number — MS. NYANNA LEIGH ARANA PA-C

Table of content: MS. NYANNA LEIGH ARANA PA-C (NPI 1114534609)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114534609 NPI number — MS. NYANNA LEIGH ARANA PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARANA
Provider First Name:
NYANNA
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
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:
1114534609
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11819 CARVEL LN
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:
77072-2820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-979-0890
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24518 NORTHWEST FREEWAY
Provider Second Line Business Practice Location Address:
MOB 2 SUITE 275
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
346-618-4400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2020

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: 363AS0400X , 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: 1175854 . This is a "NCCPA ID NUMBER" identifier . This identifiers is of the category "OTHER".




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