1588164750 NPI number — MINNIE CHEN MORALES APN

Table of content: MINNIE CHEN MORALES APN (NPI 1588164750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588164750 NPI number — MINNIE CHEN MORALES APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORALES
Provider First Name:
MINNIE
Provider Middle Name:
CHEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HINES-CHEN
Provider Other First Name:
MINNIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588164750
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 RUNNELS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIG SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79720-2529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
432-264-4228
Provider Business Mailing Address Fax Number:
432-268-9897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WEST TEXAS CENTERS
Provider Second Line Business Practice Location Address:
1501 W 11TH PLACE SUITE 104
Provider Business Practice Location Address City Name:
BIG SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79720-4122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-263-0027
Provider Business Practice Location Address Fax Number:
432-264-3297
Provider Enumeration Date:
02/14/2018

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: 363LP0808X , with the licence number:  AP136054 , 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)