1558753111 NPI number — DR. CATHERINE MAY BRIGHT KOCH AU.D.

Table of content: DR. CATHERINE MAY BRIGHT KOCH AU.D. (NPI 1558753111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558753111 NPI number — DR. CATHERINE MAY BRIGHT KOCH AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOCH
Provider First Name:
CATHERINE
Provider Middle Name:
MAY BRIGHT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
F

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:
1558753111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3456 W 97TH AVE
Provider Second Line Business Mailing Address:
UNIT 69
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80031-3262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-458-2086
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8321 SANGRE DE CRISTO RD
Provider Second Line Business Practice Location Address:
STE. 202
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80127-6425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-502-9720
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2015

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: 231H00000X , with the licence number:  AUD.0000746 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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