1578605952 NPI number — TEXAS A&M UNIVERSITY

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 1578605952 NPI number — TEXAS A&M UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS A&M UNIVERSITY
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:
1578605952
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
TEXAS A M UNIVERSITY
Provider Second Line Business Mailing Address:
1264 TAMU PHARMACY
Provider Business Mailing Address City Name:
COLLEGE STATION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77843-1264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-458-8292
Provider Business Mailing Address Fax Number:
979-458-8294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TEXAS A M UNIVERSITY
Provider Second Line Business Practice Location Address:
1264 TAMU
Provider Business Practice Location Address City Name:
COLLEGE STATION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77843-1264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-458-8292
Provider Business Practice Location Address Fax Number:
979-458-8294
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEKAWSKI
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
979-458-8299

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  06015 , 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: 06015 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00028674 . This is a "DPS REGISTRATION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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