1538153598 NPI number — ANGELA LEE HESTER RD, CDE

Table of content: ANGELA LEE HESTER RD, CDE (NPI 1538153598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538153598 NPI number — ANGELA LEE HESTER RD, CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HESTER
Provider First Name:
ANGELA
Provider Middle Name:
LEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RD, CDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VELASCO
Provider Other First Name:
ANGELA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RD, CDE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538153598
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:
435 MDG
Provider Second Line Business Mailing Address:
UNIT 3215
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09094
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
01149637186
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
435 MDG
Provider Second Line Business Practice Location Address:
UNIT 3215
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09094
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
01149637146
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2005

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: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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