1609200930 NPI number — ABILITY AND BEYOND, PLLC

Table of content: (NPI 1609200930)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609200930 NPI number — ABILITY AND BEYOND, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABILITY AND BEYOND, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1609200930
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 E WEDGEMERE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE WOODLANDS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77381-4188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-526-8892
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2475 SOUTHLINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77384-4363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-779-0083
Provider Business Practice Location Address Fax Number:
832-442-4146
Provider Enumeration Date:
08/22/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CASOGLOS-ADAMOPOULOS
Authorized Official First Name:
TINA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
832-526-8892

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  110813 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225XF0002X , with the licence number: 110813 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XN1300X , with the licence number: 110813 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0019X , with the licence number: 110813 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0200X , with the licence number: 110813 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 192907701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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