1437347382 NPI number — TANSY M. BRIGGS, DOM, L.L.C.

Table of content: (NPI 1437347382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437347382 NPI number — TANSY M. BRIGGS, DOM, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TANSY M. BRIGGS, DOM, L.L.C.
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:
1437347382
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7120 4TH ST NW STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS RANCHOS DE ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87107-6642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-899-7095
Provider Business Mailing Address Fax Number:
505-899-7095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7120 4TH ST NW STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS RANCHOS DE ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87107-6642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-899-7095
Provider Business Practice Location Address Fax Number:
505-899-7095
Provider Enumeration Date:
10/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BRIGGS
Authorized Official First Name:
TANSY
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
SINGLE MEMBER
Authorized Official Telephone Number:
505-899-7095

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  712 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1700963972 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com