1356495576 NPI number — DR. CLAUDE LAROSE M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356495576 NPI number — DR. CLAUDE LAROSE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAROSE
Provider First Name:
CLAUDE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1356495576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22999 US HIGHWAY 59 NORTH
Provider Second Line Business Mailing Address:
SUITE 290
Provider Business Mailing Address City Name:
KINGWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-348-3321
Provider Business Mailing Address Fax Number:
281-348-3305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22999 US HIGHWAY 59 NORTH
Provider Second Line Business Practice Location Address:
SUITE 290
Provider Business Practice Location Address City Name:
KINGWOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-348-3321
Provider Business Practice Location Address Fax Number:
281-348-3305
Provider Enumeration Date:
01/23/2007

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: 207KA0200X , with the licence number:  F1107 , 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: 8K1167 . This is a "BCBS INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0031KN . This is a "BCBS GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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