1437206638 NPI number — MARICELA RUBI CHAPMAN LMFT

Table of content: MARICELA RUBI CHAPMAN LMFT (NPI 1437206638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437206638 NPI number — MARICELA RUBI CHAPMAN LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPMAN
Provider First Name:
MARICELA
Provider Middle Name:
RUBI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAPMAN
Provider Other First Name:
MARICELA
Provider Other Middle Name:
RUBI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1437206638
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1519 FLORENCE RD STE 16
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KILLEEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76541-7903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-662-4038
Provider Business Mailing Address Fax Number:
254-774-9315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3411 MARKET LOOP STE 106
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76502-2771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-662-4038
Provider Business Practice Location Address Fax Number:
254-774-9315
Provider Enumeration Date:
01/03/2007

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: 106H00000X , with the licence number:  202406 , 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: 340267901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".