1427225218 NPI number — VORSTER & ASSOCIATES PC

Table of content: (NPI 1427225218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427225218 NPI number — VORSTER & ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VORSTER & ASSOCIATES PC
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:
DOCTORS EYE CLINIC
Provider Other Organization Name Type Code:
3
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:
1427225218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
710 HIGHWAY 327 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILSBEE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77656-5022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-385-2811
Provider Business Mailing Address Fax Number:
409-385-6696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
710 HIGHWAY 327 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILSBEE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77656-5022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-385-2811
Provider Business Practice Location Address Fax Number:
409-385-6696
Provider Enumeration Date:
05/12/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VORSTER
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
409-385-2811

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  3287T , 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: 197071701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".