1225634231 NPI number — BROOKE ASHLEY COVEL MED, ATC, LAT

Table of content: BROOKE ASHLEY COVEL MED, ATC, LAT (NPI 1225634231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225634231 NPI number — BROOKE ASHLEY COVEL MED, ATC, LAT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COVEL
Provider First Name:
BROOKE
Provider Middle Name:
ASHLEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MED, ATC, LAT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLER
Provider Other First Name:
BROOKE
Provider Other Middle Name:
ASHLEY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MED, ATC, LAT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225634231
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3213 74TH ST APT B
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:
79423-1393
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-678-0089
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3213 74TH ST APT B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79423-1393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-678-0089
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2020

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: 2255A2300X , with the licence number:  AT3152 , 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)





Copyright © 2007-2025 www.npivalidator.com