1346326113 NPI number — AMBROSE MOBILE HEALTH CARE ASSOCIATION

Table of content: (NPI 1346326113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346326113 NPI number — AMBROSE MOBILE HEALTH CARE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMBROSE MOBILE HEALTH CARE ASSOCIATION
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:
1346326113
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 270926
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77277-0926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-441-3311
Provider Business Mailing Address Fax Number:
281-441-3313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3663 N SAM HOUSTON PKWY E
Provider Second Line Business Practice Location Address:
STE 625
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77032-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-441-3311
Provider Business Practice Location Address Fax Number:
281-441-3313
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZAMAN
Authorized Official First Name:
FIAZ
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-441-3311

Provider Taxonomy Codes

  • Taxonomy code: 156FX1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1125833-04 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com