1316143308 NPI number — DR. PATRICIA C ESTRADA M.D.

Table of content: DR. PATRICIA C ESTRADA M.D. (NPI 1316143308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316143308 NPI number — DR. PATRICIA C ESTRADA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESTRADA
Provider First Name:
PATRICIA
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ESTRADA
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1316143308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4701 WESTBANK EXPY
Provider Second Line Business Mailing Address:
SUITE #7
Provider Business Mailing Address City Name:
MARRERO
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70072-3050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-341-0906
Provider Business Mailing Address Fax Number:
504-349-3389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4701 WESTBANK EXPY
Provider Second Line Business Practice Location Address:
SUITE #7
Provider Business Practice Location Address City Name:
MARRERO
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70072-3050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-341-0906
Provider Business Practice Location Address Fax Number:
504-349-3389
Provider Enumeration Date:
06/26/2007

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: 207Q00000X , with the licence number:  08129R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: E14875 . This is a "UPIN" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 5C660 . This is a "MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1911402 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 721302376 . This is a "PROVIDER TAXONOMIES #" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 08129R . This is a "LA. STATE LICENSE #" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com