1881677110 NPI number — DR. ELSIE NOEMI DE LA TEXERA SR. OD

Table of content: DR. ELSIE NOEMI DE LA TEXERA SR. OD (NPI 1881677110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881677110 NPI number — DR. ELSIE NOEMI DE LA TEXERA SR. OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DE LA TEXERA
Provider First Name:
ELSIE
Provider Middle Name:
NOEMI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
OD
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:
1881677110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 JUAN C. BORBON
Provider Second Line Business Mailing Address:
STE 67-113
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-312-9815
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COHEN'S FASHION OPTICAL PLAZA CAROLINA
Provider Second Line Business Practice Location Address:
AVE. JESUS M. FRAGOSO SUITE 245
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-701-3165
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2005

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: 152W00000X , with the licence number:  512 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 215202 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60702DE . This is a "TRIPLE S" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42695 . This is a "ASOCIACION MAESTRO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 068512 . This is a "GLOBAL HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100177 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00056 . This is a "VISION HEMISFERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7050040 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 890351 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: M000213 . This is a "MENONITA" identifier . This identifiers is of the category "OTHER".




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