1346642865 NPI number — MRS. JULIE ANGELICA CAUDLE MMFT, LMFTA

Table of content: MRS. JULIE ANGELICA CAUDLE MMFT, LMFTA (NPI 1346642865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346642865 NPI number — MRS. JULIE ANGELICA CAUDLE MMFT, LMFTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAUDLE
Provider First Name:
JULIE
Provider Middle Name:
ANGELICA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MMFT, LMFTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHILTON
Provider Other First Name:
JULIE
Provider Other Middle Name:
ANGELICA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346642865
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 SUGAR CREEK CENTER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-2210
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:
3 SUGAR CREEK CENTER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-2210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-736-4418
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2014

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: 106H00000X , with the licence number:  201953 , 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)





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