1477832145 NPI number — MRS. MERCY GRACE BAO ANGAN CASTRO BECKER LPT

Table of content: MRS. MERCY GRACE BAO ANGAN CASTRO BECKER LPT (NPI 1477832145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477832145 NPI number — MRS. MERCY GRACE BAO ANGAN CASTRO BECKER LPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASTRO BECKER
Provider First Name:
MERCY GRACE
Provider Middle Name:
BAO ANGAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CASTRO
Provider Other First Name:
MERCY GRACE
Provider Other Middle Name:
BAO ANGAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477832145
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
837 CYPRESS CREEK PKWY
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77090-3423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-586-3888
Provider Business Mailing Address Fax Number:
281-440-2020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
837 CYPRESS CREEK PKWY
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77090-3423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-586-3888
Provider Business Practice Location Address Fax Number:
281-440-2020
Provider Enumeration Date:
08/11/2011

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: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1209803 . This is a "TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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