1962683482 NPI number — H & S CHAMPS MEDICAL LTD

Table of content: (NPI 1962683482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962683482 NPI number — H & S CHAMPS MEDICAL LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H & S CHAMPS MEDICAL LTD
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:
CHAMPS MEDICAL
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:
1962683482
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7718 LOUIS PASTEUR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229-3402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-1414
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 N KING ST
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
SEGUIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78155-5836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-303-0267
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HERNANDEZ
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CEO OWNER
Authorized Official Telephone Number:
210-614-1414

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0046884 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: 0046750 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 0046750 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 0046884 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 0046884 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 0046750 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 142484802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 141825301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 142484801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".