1477659068 NPI number — TEXAS SCHOOL OF NURSING & ALLIED HEALTH PROFESSIONALS

Table of content: (NPI 1477659068)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477659068 NPI number — TEXAS SCHOOL OF NURSING & ALLIED HEALTH PROFESSIONALS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS SCHOOL OF NURSING & ALLIED HEALTH PROFESSIONALS
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:
TEXAS WELLNESS HEALTH 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:
1477659068
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 672342
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77267-2342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-256-1752
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 N SAM HOUSTON PKWY E
Provider Second Line Business Practice Location Address:
SUITE 146
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77060-4018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-256-1752
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FISHER
Authorized Official First Name:
LATRONICA
Authorized Official Middle Name:
TARSUNET
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
713-256-1752

Provider Taxonomy Codes

  • Taxonomy code: 163WC1500X , with the licence number:  679005 , 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)