1073266508 NPI number — JULIO ALEXANDER MACHUCA MS. PLMHP

Table of content: SARAH MARIE WEIL-SCHULTZ MA (NPI 1740090323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073266508 NPI number — JULIO ALEXANDER MACHUCA MS. PLMHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACHUCA
Provider First Name:
JULIO
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS. PLMHP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1073266508
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3514 S 153RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68144-5518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-714-5426
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8790 F ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68127-1524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-262-4808
Provider Business Practice Location Address Fax Number:
844-895-1590
Provider Enumeration Date:
02/03/2022

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com