1689041808 NPI number — IVY ALCALA DANO FNP-C

Table of content: IVY ALCALA DANO FNP-C (NPI 1689041808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689041808 NPI number — IVY ALCALA DANO FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANO
Provider First Name:
IVY
Provider Middle Name:
ALCALA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
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:
1689041808
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 720085
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-0085
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-227-5715
Provider Business Mailing Address Fax Number:
956-630-0472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 E SAVANNAH AVE STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-686-7611
Provider Business Practice Location Address Fax Number:
956-618-3146
Provider Enumeration Date:
08/24/2015

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: 363L00000X , with the licence number:  AP128771 , 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: 8045NX . This is a "SOLO BCBS LINKED TO RAMCORP MEDICAL PA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 441686ZSJC . This is a "INDIVIDUAL MEDICARE LINKED TO RAMCORP MEDICAL PA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8JK486 . This is a "SOLO BCBS LINKED TO MD HOSPITALISTS PLLC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P01666640 . This is a "INDIVIDUAL RR MEDICARE LINKED TO RAMCORP MEDICAL PA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8047NS . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 350181902 . This is a "INDIVIDUAL MEDICAID LINKED TO RAMCORP MEDICALPA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 692618 . This is a "INDIVIDUAL MEDICARE LINKED MD HOSPITALISTS PLLC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 3501819-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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