1184868614 NPI number — RENAISSANCE ASSISTED LIVING, L.L.C

Table of content: DR. BERNABE BARR URBANO AMBROSIO DMD (NPI 1952454019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184868614 NPI number — RENAISSANCE ASSISTED LIVING, L.L.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RENAISSANCE ASSISTED LIVING, L.L.C
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:
1184868614
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7710 KITTERY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76002-4177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7315 OAKSTONE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75249-1312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-298-0507
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
NGWA
Authorized Official First Name:
IRENE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
972-298-0507

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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