1720258353 NPI number — ALTERNATIVE PAIN CARE INSTITUTE, LLP

Table of content: (NPI 1720258353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720258353 NPI number — ALTERNATIVE PAIN CARE INSTITUTE, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTERNATIVE PAIN CARE INSTITUTE, LLP
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:
1720258353
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1067
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EULESS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76039-1067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5833 SPOHN DR
Provider Second Line Business Practice Location Address:
SUITE 401
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78414-4135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-992-9432
Provider Business Practice Location Address Fax Number:
361-992-3978
Provider Enumeration Date:
03/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
VALTCHANOV
Authorized Official First Name:
VALENTIN
Authorized Official Middle Name:
PETKOV
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
682-433-8072

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X , with the licence number:  D5354 , 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: 611649100 . This is a "DOL FECA" identifier . This identifiers is of the category "OTHER".




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