1700960580 NPI number — DISABILITY SERVICES OF THE SOUTHWEST, INC

Table of content: (NPI 1700960580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700960580 NPI number — DISABILITY SERVICES OF THE SOUTHWEST, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DISABILITY SERVICES OF THE SOUTHWEST, INC
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:
1700960580
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6243 IH 10 WEST
Provider Second Line Business Mailing Address:
STE 375
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-798-0123
Provider Business Mailing Address Fax Number:
210-785-6649

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6243 IH 10 WEST
Provider Second Line Business Practice Location Address:
SUITE 375
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-798-0123
Provider Business Practice Location Address Fax Number:
210-785-6649
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
N
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
210-798-0123

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251X00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 008033 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 017075 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 017316 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 004154 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 017842 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 185516501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 185516502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015918 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 007652 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 007556 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 007572 . This is a "HCSSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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