1528640257 NPI number — ASHLEY LAUREN CARDONA NP

Table of content: ASHLEY LAUREN CARDONA NP (NPI 1528640257)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528640257 NPI number — ASHLEY LAUREN CARDONA NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARDONA
Provider First Name:
ASHLEY
Provider Middle Name:
LAUREN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROMAGE
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
LAUREN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528640257
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
169 S IH 35
Provider Second Line Business Mailing Address:
STE 169
Provider Business Mailing Address City Name:
NEW BRAUNFELS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78130-4817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-620-9429
Provider Business Mailing Address Fax Number:
830-620-9495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
169 S IH 35
Provider Second Line Business Practice Location Address:
STE 169
Provider Business Practice Location Address City Name:
NEW BRAUNFELS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78130-4817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-620-9429
Provider Business Practice Location Address Fax Number:
830-620-9495
Provider Enumeration Date:
04/22/2021

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: 363L00000X , with the licence number:  1034358 , 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)