1740931146 NPI number — EMPOWERING ME EMPOWERING THE MENTAL EMPOWERING THE EMOTIONAL, LLC

Table of content: (NPI 1740931146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740931146 NPI number — EMPOWERING ME EMPOWERING THE MENTAL EMPOWERING THE EMOTIONAL, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPOWERING ME EMPOWERING THE MENTAL EMPOWERING THE EMOTIONAL, LLC
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:
1740931146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
702 RICHLAND HILLS DR UNIT 769118
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78245-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-274-4919
Provider Business Mailing Address Fax Number:
210-239-5509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 NE LOOP 410 STE 116
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78216-5844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-274-4919
Provider Business Practice Location Address Fax Number:
210-239-5509
Provider Enumeration Date:
01/17/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BANKS
Authorized Official First Name:
NATHASHA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER OPERATOR
Authorized Official Telephone Number:
210-274-4919

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 175T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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