1346462116 NPI number — MALCOLM W ALMOND III

Table of content: (NPI 1346462116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346462116 NPI number — MALCOLM W ALMOND III

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MALCOLM W ALMOND III
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:
1346462116
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1004 FORD STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78643-2346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-247-4700
Provider Business Mailing Address Fax Number:
325-247-3000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1004 FORD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78643-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-247-4700
Provider Business Practice Location Address Fax Number:
325-247-3000
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALMOND
Authorized Official First Name:
MALCOLM
Authorized Official Middle Name:
WILLIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
325-247-4700

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  00233 , 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)

  • Identifier: 4525575 . This is a "NABP" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com