1609043280 NPI number — PATRICIA ANN EMIG RNC

Table of content: PATRICIA ANN EMIG RNC (NPI 1609043280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609043280 NPI number — PATRICIA ANN EMIG RNC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EMIG
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RNC
Provider Gender Code:
F

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:
1609043280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 UNIVERSITY DRIVE EAST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
COLLEGE STATION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-846-1100
Provider Business Mailing Address Fax Number:
979-260-9390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3370 SOUTH TEXAS AVENUE
Provider Second Line Business Practice Location Address:
#B
Provider Business Practice Location Address City Name:
BRYAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-595-1700
Provider Business Practice Location Address Fax Number:
979-595-1740
Provider Enumeration Date:
05/13/2008

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: 363LW0102X , with the licence number:  577389 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 364SM0705X , with the licence number: 577389 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 45-1942 . This is a "BRYAN COLLEGE STATION CHC MEDICARE FACILITY NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1544678-01 . This is a "BRYAN COLLEGE STATION CHC FACILITY TPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com