1215046412 NPI number — DR. XOCHITL DUARTE ANDERTON DDS

Table of content: DR. XOCHITL DUARTE ANDERTON DDS (NPI 1215046412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215046412 NPI number — DR. XOCHITL DUARTE ANDERTON DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERTON
Provider First Name:
XOCHITL
Provider Middle Name:
DUARTE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAMOS
Provider Other First Name:
XOCHITL
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215046412
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9105 LOLA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-495-3600
Provider Business Mailing Address Fax Number:
806-303-5003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1002 N. AVENUE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POST
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-495-3600
Provider Business Practice Location Address Fax Number:
806-303-5003
Provider Enumeration Date:
08/30/2006

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: 122300000X , with the licence number:  21263 , 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)





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