1881700508 NPI number — A PETERS INC

Table of content: (NPI 1881700508)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881700508 NPI number — A PETERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A PETERS 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:
STAT CARE ORTHOTICS & PROSTHETICS
Provider Other Organization Name Type Code:
3
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:
1881700508
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 90116
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77290-0116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-827-9909
Provider Business Mailing Address Fax Number:
713-827-9919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8955 KATY FWY STE 306
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-1627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-827-9909
Provider Business Practice Location Address Fax Number:
713-827-9919
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KEARNS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
713-827-9909

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  101446 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 101446 , 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)

  • Identifier: 3319311-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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