1336341627 NPI number — THERAPY FIRST LLC

Table of content: (NPI 1336341627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336341627 NPI number — THERAPY FIRST LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPY FIRST 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:
THERAPY FIRST
Provider Other Organization Name Type Code:
5
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:
1336341627
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78468-8150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-993-4778
Provider Business Mailing Address Fax Number:
361-993-4779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2101 AIRLINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78414-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-993-4778
Provider Business Practice Location Address Fax Number:
361-993-4779
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PIERCE
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
LILES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
361-993-4778

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  661590000 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: 556250000 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X , with the licence number: 1016244 , 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: 8T7609 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1336341627 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0001QA . This is a "BLUE CROSS BLUE SHIELD GROUP NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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