1861604811 NPI number — BREATH OF LIFE RESEARCH INSTITUTE INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861604811 NPI number — BREATH OF LIFE RESEARCH INSTITUTE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BREATH OF LIFE RESEARCH INSTITUTE 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:
1861604811
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 197
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARKER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77413-0197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-398-7353
Provider Business Mailing Address Fax Number:
281-398-7357

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21715 KINGSLAND BLVD
Provider Second Line Business Practice Location Address:
SUITE # 103
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77450-2543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-398-7353
Provider Business Practice Location Address Fax Number:
281-398-7357
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
OWEN
Authorized Official First Name:
GWENDOLYN
Authorized Official Middle Name:
DENISE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
281-398-7353

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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