1851828008 NPI number — DR. ERIK THOMAS ALBACH MD

Table of content: DR. ERIK THOMAS ALBACH MD (NPI 1851828008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851828008 NPI number — DR. ERIK THOMAS ALBACH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBACH
Provider First Name:
ERIK
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1851828008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7471 S CLINTON ST
Provider Second Line Business Mailing Address:
APT 3303
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-3793
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-500-6500
Provider Business Mailing Address Fax Number:
713-500-6497

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6431 FANNIN STREET
Provider Second Line Business Practice Location Address:
1.134
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-5389
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
(713) 500-6500
Provider Business Practice Location Address Fax Number:
713-500-6497
Provider Enumeration Date:
05/18/2017

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: TL.0007396 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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