1679800940 NPI number — LINDA D. POPE, M.D.,P.A.

Table of content: (NPI 1679800940)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679800940 NPI number — LINDA D. POPE, M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINDA D. POPE, M.D.,P.A.
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:
LINDA D. POPE-PEGRAM, MD
Provider Other Organization Name Type Code:
4
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:
1679800940
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 BINZ ST
Provider Second Line Business Mailing Address:
SUITE 540
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77004-6900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-523-3200
Provider Business Mailing Address Fax Number:
713-523-3201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 BINZ ST
Provider Second Line Business Practice Location Address:
SUITE 540
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77004-6900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-523-3200
Provider Business Practice Location Address Fax Number:
713-523-3201
Provider Enumeration Date:
11/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
POPE
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
DARLENE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
713-523-3200

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  F9969 , 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: 098524401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2344514 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 850 872 . This is a "GREATER HOUSTON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00G630 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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