1952802001 NPI number — OUR COMMUNITY BIRTH CENTER PLLC

Table of content: (NPI 1952802001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952802001 NPI number — OUR COMMUNITY BIRTH CENTER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OUR COMMUNITY BIRTH CENTER PLLC
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:
BAY AREA COMMUNITY BIRTH CENTER
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:
1952802001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8453 HOWARD DR STE B
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:
77017-4731
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-472-5255
Provider Business Mailing Address Fax Number:
855-472-3600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8453 HOWARD DR STE B
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:
77017-4731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-472-5255
Provider Business Practice Location Address Fax Number:
855-472-3600
Provider Enumeration Date:
02/23/2018

Additional Information

Authorized Official

Authorized Official Last Name:
PALACIO
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR/CLINICAL DIRECTOR
Authorized Official Telephone Number:
713-472-5525

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QB0400X , with the licence number: 150069 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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