1437254851 NPI number — LUIS MANUEL ARCE 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 1437254851 NPI number — LUIS MANUEL ARCE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARCE
Provider First Name:
LUIS
Provider Middle Name:
MANUEL
Provider Name Prefix Text:
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:
1437254851
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 33724
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76162-3724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-346-0847
Provider Business Mailing Address Fax Number:
817-346-0847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
759 HEINTZELMAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINERAL WELLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76067-9273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-325-6933
Provider Business Practice Location Address Fax Number:
940-325-4489
Provider Enumeration Date:
09/13/2006

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: 207Q00000X , with the licence number:  J2482 , 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)