1457431876 NPI number — AFREEN S PAPPA MD

Table of content: AFREEN S PAPPA MD (NPI 1457431876)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457431876 NPI number — AFREEN S PAPPA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAPPA
Provider First Name:
AFREEN
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1457431876
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 BUTTERFIELD RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
DOWNERS GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60515-1050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-725-2832
Provider Business Mailing Address Fax Number:
877-489-5993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2615 SOUTHWEST FWY
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77098-4609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-527-8731
Provider Business Practice Location Address Fax Number:
713-527-8731
Provider Enumeration Date:
10/17/2006

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: 207Q00000X , with the licence number:  J4415 , 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: 340731 . This is a "GROUP MEDICARE PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 340739 . This is a "GROUP MEDICARE PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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