1174010698 NPI number — INSPIRATION THERAPY PLLC

Table of content: (NPI 1174010698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174010698 NPI number — INSPIRATION THERAPY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSPIRATION THERAPY PLLC
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:
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:
1174010698
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29715 WAVERLY PARK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKSHIRE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77423-7405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29715 WAVERLY PARK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKSHIRE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77423-7405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-853-9881
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HOWARD, JOHNSON
Authorized Official First Name:
RONETTE, TANGENT
Authorized Official Middle Name:
Authorized Official Title or Position:
SLP/ OTR
Authorized Official Telephone Number:
832-996-0930

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  110782 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 116168 , 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: 1932510773 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1629591516 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".