1629510342 NPI number — ASHLEY B. DRESSEN P.A.

Table of content: ASHLEY B. DRESSEN P.A. (NPI 1629510342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629510342 NPI number — ASHLEY B. DRESSEN P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DRESSEN
Provider First Name:
ASHLEY
Provider Middle Name:
B.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALEXANDER
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
B.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1629510342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
763 E US HIGHWAY 80 STE 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75126-8676
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-564-0050
Provider Business Mailing Address Fax Number:
972-564-2138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 SCENIC DR STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROWLETT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75088-2695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-475-7555
Provider Business Practice Location Address Fax Number:
972-412-0935
Provider Enumeration Date:
11/11/2016

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: 363A00000X , with the licence number:  PA10993 , 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)