1730489600 NPI number — AUREA LUISA NEGRON LVN

Table of content: AUREA LUISA NEGRON LVN (NPI 1730489600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730489600 NPI number — AUREA LUISA NEGRON LVN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEGRON
Provider First Name:
AUREA
Provider Middle Name:
LUISA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LVN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NEGRON PAGAN
Provider Other First Name:
AUREA
Provider Other Middle Name:
LUISA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730489600
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14200 SARAH ANN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78725-4006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-803-0200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14200 SARAH ANN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78725-4006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-803-0200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2010

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: 164W00000X , with the licence number:  226178 , 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)