1740472273 NPI number — MEDICAL TECHNOLOGIES, INC.

Table of content: (NPI 1740472273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740472273 NPI number — MEDICAL TECHNOLOGIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL TECHNOLOGIES, 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:
6
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:
1740472273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 W COLLEGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE CHARLES
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70605-1527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-491-1100
Provider Business Mailing Address Fax Number:
337-491-1122

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 CENTURY PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE C-150
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77073-6128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-893-5573
Provider Business Practice Location Address Fax Number:
281-893-5582
Provider Enumeration Date:
08/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MONLEZUN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
337-491-1100

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1904534 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com