1770571499 NPI number — MRS. SCARLETT G KUTCH B.B.A

Table of content: MRS. SCARLETT G KUTCH B.B.A (NPI 1770571499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770571499 NPI number — MRS. SCARLETT G KUTCH B.B.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUTCH
Provider First Name:
SCARLETT
Provider Middle Name:
G
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
B.B.A
Provider Gender Code:
F

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:
1770571499
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3114 E WEBBER DR
Provider Second Line Business Mailing Address:
MAIL ONLY
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77584-9419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-419-3217
Provider Business Mailing Address Fax Number:
832-295-9336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3114 E WEBBER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-9419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-419-3217
Provider Business Practice Location Address Fax Number:
832-295-9336
Provider Enumeration Date:
10/06/2005

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: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: S00527 . This is a "TRAILBLAZEREDISUBMITTERID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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