1629099262 NPI number — CITY OF MONT BELVIEU

Table of content: (NPI 1629099262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629099262 NPI number — CITY OF MONT BELVIEU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF MONT BELVIEU
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:
6
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:
1629099262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1048
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONT BELVIEU
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77580-1048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-576-2021
Provider Business Mailing Address Fax Number:
281-385-2194

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11607 EAGLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONT BELVIEU
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-576-2021
Provider Business Practice Location Address Fax Number:
281-385-2194
Provider Enumeration Date:
07/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALLUM
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT FIRE CHIEF
Authorized Official Telephone Number:
281-576-2213

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  36002 , 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)

  • Identifier: 517821 . This is a "BC/BS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 590015294 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000546401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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