1508884412 NPI number — JAVIER A SAENZ MD PA

Table of content: TONJANIKA BALLARD PMHNP (NPI 1255717088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508884412 NPI number — JAVIER A SAENZ MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAVIER A SAENZ MD PA
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:
6
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:
1508884412
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1380
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA JOYA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78560-1380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-585-1688
Provider Business Mailing Address Fax Number:
956-585-8008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 E EXPWY 83
Provider Second Line Business Practice Location Address:
STE 4
Provider Business Practice Location Address City Name:
LA JOYA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78560-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-585-1688
Provider Business Practice Location Address Fax Number:
956-585-8008
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SAENZ
Authorized Official First Name:
JAVIER
Authorized Official Middle Name:
ANDRES
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
956-585-1688

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 081982301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: CK4621 . This is a "RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00D05C . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 178492401 . This is a "OWCP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 081982302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com