1144396946 NPI number — MRS. CAROL J WALTER LPC

Table of content: MRS. CAROL J WALTER LPC (NPI 1144396946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144396946 NPI number — MRS. CAROL J WALTER LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALTER
Provider First Name:
CAROL
Provider Middle Name:
J
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

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:
1144396946
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1852 LOCKHILL SELMA RD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78213-1567
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-340-1000
Provider Business Mailing Address Fax Number:
210-340-1004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1852 LOCKHILL SELMA RD
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78213-1567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-340-1000
Provider Business Practice Location Address Fax Number:
210-340-1004
Provider Enumeration Date:
11/27/2006

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: 101YP2500X , with the licence number:  11928 , 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: 237502 . This is a "VALUE OPTIONS ID NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7521008 . This is a "AETNA PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 125915 . This is a "MHN IDENTIFIER NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 3225LC . This is a "BLUE CROSS BLUE SHIELD ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com