1639113368 NPI number — SOUTH TEXAS PULMONARY AND CRITICAL CARE ASSOCIATES

Table of content: (NPI 1639113368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639113368 NPI number — SOUTH TEXAS PULMONARY AND CRITICAL CARE ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH TEXAS PULMONARY AND CRITICAL CARE ASSOCIATES
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:
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:
1639113368
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 S ALAMEDA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78404-3109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-884-2687
Provider Business Mailing Address Fax Number:
361-884-3425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 S ALAMEDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78404-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-884-2687
Provider Business Practice Location Address Fax Number:
361-884-3425
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NARANG
Authorized Official First Name:
RAJEEV
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
361-884-2687

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  J7600 , 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: 085702101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com