1013085497 NPI number — MISS THELMA ALICIA FIGUEROA LOT, C/NDT

Table of content: MISS THELMA ALICIA FIGUEROA LOT, C/NDT (NPI 1013085497)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013085497 NPI number — MISS THELMA ALICIA FIGUEROA LOT, C/NDT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIGUEROA
Provider First Name:
THELMA
Provider Middle Name:
ALICIA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LOT, C/NDT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUJICA
Provider Other First Name:
THELMA
Provider Other Middle Name:
F.
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BS. LIC. O.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013085497
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7007 N 10TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-661-0475
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7007 N 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-661-0475
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2006

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: 225X00000X , with the licence number:  104661 , 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: 143404501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 742965954 . This is a "FACILITY TAX ID NO." identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".