1467401661 NPI number — DR. NANCY G HOOVER MD

Table of content: DR. NANCY G HOOVER MD (NPI 1467401661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467401661 NPI number — DR. NANCY G HOOVER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOVER
Provider First Name:
NANCY
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
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:
GARRETT
Provider Other First Name:
NANCY
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467401661
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3534 PUESTA DE SOL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78261-2415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-481-3574
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1650 COCHRANE CIR
Provider Second Line Business Practice Location Address:
DEPT OF ANESTHESIA
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913-4613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-7942
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2006

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: 2080P0203X , with the licence number:  49902 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: ME135088 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP3000X , with the licence number: P5644 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 485742333 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107631900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".