1639232218 NPI number — CAPLAND CENTER FOR COMMUNICATION DISORDERS, INC.

Table of content: (NPI 1639232218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639232218 NPI number — CAPLAND CENTER FOR COMMUNICATION DISORDERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPLAND CENTER FOR COMMUNICATION DISORDERS, INC.
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:
1639232218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2660 AERO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT ARTHUR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77640-1528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-729-2227
Provider Business Mailing Address Fax Number:
409-729-2001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2660 AERO DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT ARTHUR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77640-1528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-729-2227
Provider Business Practice Location Address Fax Number:
409-729-2001
Provider Enumeration Date:
12/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HALE
Authorized Official First Name:
DORIS
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
409-729-2227

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 155796901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 746049 USHCH . This is a "UTMB-CHIPS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0933135 . This is a "CIGNA HEALTHCARE OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0079CE . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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