1225322787 NPI number — MS. DORA ANN CISNEROS LCSW

Table of content: MS. DORA ANN CISNEROS LCSW (NPI 1225322787)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225322787 NPI number — MS. DORA ANN CISNEROS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CISNEROS
Provider First Name:
DORA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1225322787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26325 NORTHGATE CROSSING BLVD APT 812
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77373-5641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-702-8873
Provider Business Mailing Address Fax Number:
713-583-9144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3850 FM 2920 RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77388-4123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-528-2810
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2011

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: 1041C0700X , with the licence number:  50914 , 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)