1497756175 NPI number — SWAPAN DUBEY M.D.

Table of content: SWAPAN DUBEY M.D. (NPI 1497756175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497756175 NPI number — SWAPAN DUBEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUBEY
Provider First Name:
SWAPAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1497756175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
311 REINERMAN ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-567-9511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1211 HIGHWAY 6
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-4941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-494-4832
Provider Business Practice Location Address Fax Number:
281-494-7399
Provider Enumeration Date:
08/03/2005

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: 207P00000X , with the licence number:  K8742 , 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: 104138607 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104138604 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104138601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104138603 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 89313X . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8S4402 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 104138606 . This is a "CSHCN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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