1790172310 NPI number — ITOX, LLC

Table of content: (NPI 1790172310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790172310 NPI number — ITOX, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ITOX, 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:
1790172310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 W 47TH ST
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64112-1659
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:
525 ROUND ROCK WEST DR
Provider Second Line Business Practice Location Address:
SUITE B200
Provider Business Practice Location Address City Name:
ROUND ROCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78681-5020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-802-5227
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ENGLISH
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
719-440-4717

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  45D2082145 , 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)