1164594255 NPI number — MRS. NORMA ORALIA VAZQUEZ M.ED., L.P.C.

Table of content: MRS. NORMA ORALIA VAZQUEZ M.ED., L.P.C. (NPI 1164594255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164594255 NPI number — MRS. NORMA ORALIA VAZQUEZ M.ED., L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAZQUEZ
Provider First Name:
NORMA
Provider Middle Name:
ORALIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED., L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSADO
Provider Other First Name:
NORMA
Provider Other Middle Name:
ORALIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED., L.P.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1164594255
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7500 VISCOUNT BLVD STE C60
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79925-5693
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-207-4047
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7500 VISCOUNT BLVD STE C60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79925-5693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-207-4047
Provider Business Practice Location Address Fax Number:
915-248-0076
Provider Enumeration Date:
11/14/2006

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:  59312 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 59312 , 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: 1809667-03 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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