1205421013 NPI number — MRS. YVONNE SONG FERRELL ACUPUNCTURIST

Table of content: MRS. YVONNE SONG FERRELL ACUPUNCTURIST (NPI 1205421013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205421013 NPI number — MRS. YVONNE SONG FERRELL ACUPUNCTURIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRELL
Provider First Name:
YVONNE
Provider Middle Name:
SONG
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ACUPUNCTURIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERRELL
Provider Other First Name:
YVONNE
Provider Other Middle Name:
SONG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ACUPUNCTURIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1205421013
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
497 N RESLER DR STE C16829
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:
79912-2744
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-760-7960
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
497 N RESLER DR STE C16829
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:
79912-2744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-760-7960
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2021

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: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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