1447578109 NPI number — ANN PRICE REYNOLDS, PLLC

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 1447578109 NPI number — ANN PRICE REYNOLDS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANN PRICE REYNOLDS, PLLC
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:
1447578109
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3513 LAS MORAS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEMPLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76502-2134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-742-0299
Provider Business Mailing Address Fax Number:
254-742-0434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 MARLANDWOOD RD
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76502-3329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-742-0299
Provider Business Practice Location Address Fax Number:
254-742-0434
Provider Enumeration Date:
05/05/2010

Additional Information

Authorized Official

Authorized Official Last Name:
REYNOLDS
Authorized Official First Name:
ANN
Authorized Official Middle Name:
PRICE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
254-718-6527

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  10588 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 3364 , 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: 1326046905 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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