1356330096 NPI number — ASSOCIATION ANESTHESIOLOGISTS

Table of content: MRS. BRENDA LEE THIELEMIER DC (NPI 1164406070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356330096 NPI number — ASSOCIATION ANESTHESIOLOGISTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATION ANESTHESIOLOGISTS
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:
1356330096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT 5010 BOX 4283
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77210-4283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-394-4445
Provider Business Mailing Address Fax Number:
706-650-1034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4747 BELLAIRE BLVD
Provider Second Line Business Practice Location Address:
SUITE 580
Provider Business Practice Location Address City Name:
BELLAIRE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77401-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-659-3284
Provider Business Practice Location Address Fax Number:
713-659-2534
Provider Enumeration Date:
10/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SYKES
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-659-3284

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , 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: 126660303 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: CC8131 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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