1457461709 NPI number — UTTURKAR & ASSOCIATES

Table of content: (NPI 1457461709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457461709 NPI number — UTTURKAR & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UTTURKAR & ASSOCIATES
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:
1457461709
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
260 RESACA POINT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78526-4091
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-581-0303
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E ALTON GLOOR BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78526-3354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-581-0303
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UTTURKAR
Authorized Official First Name:
ANANT
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
956-581-0303

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 188196301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0074PS . This is a "BC BS TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 137848113 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".