1659907160 NPI number — MRS. ANGELITA ANCHETA PARRISH NP

Table of content: (NPI 1720350812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659907160 NPI number — MRS. ANGELITA ANCHETA PARRISH NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARRISH
Provider First Name:
ANGELITA
Provider Middle Name:
ANCHETA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RALLOS
Provider Other First Name:
ANGELITA
Provider Other Middle Name:
ANCHETA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659907160
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
180 TEE TAW CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75092-6998
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-571-6914
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2340 E TRINITY MILLS RD STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75006-1946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-442-5209
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2020

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: 363LA2100X , with the licence number:  AP141776 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: AP141776 , 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)