1265832851 NPI number — WAYNE DEES PSYCHOLOGICAL ASSOCIATES, PA

Table of content: NICHOLAS EUGENE LEMKE RD (NPI 1255291282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265832851 NPI number — WAYNE DEES PSYCHOLOGICAL ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAYNE DEES PSYCHOLOGICAL ASSOCIATES, PA
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:
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:
1265832851
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CYPRESS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77410-2320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-658-7459
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12500 BARKER CYPRESS RD
Provider Second Line Business Practice Location Address:
5201
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77429-8239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-658-7459
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/02/2014

Additional Information

Authorized Official

Authorized Official Last Name:
DEES
Authorized Official First Name:
WAYNE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
206-658-7459

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  34276 , 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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