1164137188 NPI number — MS. ANAIYA BAUKMAN M.S., LPA

Table of content: MS. ANAIYA BAUKMAN M.S., LPA (NPI 1164137188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164137188 NPI number — MS. ANAIYA BAUKMAN M.S., LPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAUKMAN
Provider First Name:
ANAIYA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., LPA
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:
1164137188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9595 ROMBAUER RD APT 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COPPELL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75019-1203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-994-9478
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1175 KINWEST PKWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75063-3409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-940-9089
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2023

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: 103TC0700X , with the licence number:  40159 , 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: 40159 . This is a "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".