1225371826 NPI number — NEUROPATHY RELIEF CENTERS INC

Table of content: MAILY THUY NGUYEN PHARMD (NPI 1184236853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225371826 NPI number — NEUROPATHY RELIEF CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROPATHY RELIEF CENTERS INC
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:
6
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:
1225371826
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5755 COLLEGE STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAUMONT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-840-9300
Provider Business Mailing Address Fax Number:
409-842-4960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2503 S AVENUE A
Provider Second Line Business Practice Location Address:
SUITE NO1
Provider Business Practice Location Address City Name:
YUMA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85364-7173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-783-3656
Provider Business Practice Location Address Fax Number:
928-329-4495
Provider Enumeration Date:
04/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RISING
Authorized Official First Name:
BODRE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
409-289-1411

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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