1285698068 NPI number — LARRY P URBEN MS ATC LAT C PED

Table of content: LARRY P URBEN MS ATC LAT C PED (NPI 1285698068)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285698068 NPI number — LARRY P URBEN MS ATC LAT C PED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URBEN
Provider First Name:
LARRY
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS ATC LAT C PED
Provider Gender Code:
M

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:
1285698068
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6100 CARLTON CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070-8789
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-725-6988
Provider Business Mailing Address Fax Number:
972-767-3017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6842 LEBANON RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-7478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-913-6684
Provider Business Practice Location Address Fax Number:
972-767-3017
Provider Enumeration Date:
04/17/2006

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: 225000000X , with the licence number:  3204 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2255A2300X , with the licence number: AT3024 , 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)





Copyright © 2007-2025 www.npivalidator.com