1932104486 NPI number — DR. CHRISTINE DE ALENCAR ALBRECHT M.D.

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 1932104486 NPI number — DR. CHRISTINE DE ALENCAR ALBRECHT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBRECHT
Provider First Name:
CHRISTINE
Provider Middle Name:
DE ALENCAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALBRECHT
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1932104486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
855 BELANGER ST
Provider Second Line Business Mailing Address:
STE 209
Provider Business Mailing Address City Name:
HOUMA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70360-4463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-873-0112
Provider Business Mailing Address Fax Number:
985-857-8624

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
855 BELANGER ST
Provider Second Line Business Practice Location Address:
STE 209
Provider Business Practice Location Address City Name:
HOUMA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70360-4463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-873-0112
Provider Business Practice Location Address Fax Number:
985-857-8624
Provider Enumeration Date:
06/20/2005

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: 174400000X , with the licence number:  11547R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1680001 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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