1609977180 NPI number — DR. J LYNNE ARMSTRONG EDD CLINICAL COUNSEL

Table of content: DR. J LYNNE ARMSTRONG EDD CLINICAL COUNSEL (NPI 1609977180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609977180 NPI number — DR. J LYNNE ARMSTRONG EDD CLINICAL COUNSEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARMSTRONG
Provider First Name:
J LYNNE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
EDD CLINICAL COUNSEL
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:
1609977180
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6800 PARK TEN BLVD
Provider Second Line Business Mailing Address:
103N
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-735-2740
Provider Business Mailing Address Fax Number:
210-735-3572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6800 PARK TEN BLVD
Provider Second Line Business Practice Location Address:
103N
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-735-2740
Provider Business Practice Location Address Fax Number:
210-735-3572
Provider Enumeration Date:
09/26/2006

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: 101Y00000X , with the licence number:  561 , 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)





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