1457304057 NPI number — ALLMEDPHYSICIANS, PLLC

Table of content: (NPI 1457304057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457304057 NPI number — ALLMEDPHYSICIANS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLMEDPHYSICIANS, PLLC
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:
1457304057
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUDA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78610-0007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-295-7877
Provider Business Mailing Address Fax Number:
512-532-7762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1760 FM 967
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BUDA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78610-2884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-295-7877
Provider Business Practice Location Address Fax Number:
512-532-7762
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARNEY
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
512-295-7877

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  M1039 , 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: 0058NP . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 179994201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com