1659606283 NPI number — TERESA DIANE PARTIN LPC

Table of content: TERESA DIANE PARTIN LPC (NPI 1659606283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659606283 NPI number — TERESA DIANE PARTIN LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARTIN
Provider First Name:
TERESA
Provider Middle Name:
DIANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WELCH
Provider Other First Name:
TERESA
Provider Other Middle Name:
DIANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659606283
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1901 CENTRAL DR
Provider Second Line Business Mailing Address:
SUITE 506
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76021-5869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-685-8788
Provider Business Mailing Address Fax Number:
817-685-8789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1901 CENTRAL DR
Provider Second Line Business Practice Location Address:
SUITE 506
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76021-5869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-685-8788
Provider Business Practice Location Address Fax Number:
817-685-8789
Provider Enumeration Date:
10/15/2009

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: 101YP2500X , with the licence number:  60857 , 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: 60857 . This is a "LPC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com