1396267969 NPI number — MRS. TEODORA MANLANGIT ORDAS RPT

Table of content: MRS. TEODORA MANLANGIT ORDAS RPT (NPI 1396267969)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396267969 NPI number — MRS. TEODORA MANLANGIT ORDAS RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORDAS
Provider First Name:
TEODORA
Provider Middle Name:
MANLANGIT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ATIENZA
Provider Other First Name:
TEODORA
Provider Other Middle Name:
MANLANGIT
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396267969
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 S SMITH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUSHVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46173-7127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-561-2956
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 SMITH DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSHVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-561-2956
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2017

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: 225100000X , with the licence number:  05003762A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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