1447856588 NPI number — THE COGNITIVE BEHAVIORAL INSTITUTE OF EL PASO

Table of content: DR. DAVID VICTOR HANSEN M.D. (NPI 1538277629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447856588 NPI number — THE COGNITIVE BEHAVIORAL INSTITUTE OF EL PASO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE COGNITIVE BEHAVIORAL INSTITUTE OF EL PASO
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:
1447856588
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1316 N YARBROUGH DR STE 2A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79925-7803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-433-4183
Provider Business Mailing Address Fax Number:
844-691-1283

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1316 N YARBROUGH DR STE 2A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79925-7803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-373-6021
Provider Business Practice Location Address Fax Number:
844-691-1283
Provider Enumeration Date:
12/04/2020

Additional Information

Authorized Official

Authorized Official Last Name:
VILLALOBOS
Authorized Official First Name:
GRISELDA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
915-433-4183

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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