1720182173 NPI number — MRS. NICOLE P SPRINGER PHD LMFT

Table of content: MRS. NICOLE P SPRINGER PHD LMFT (NPI 1720182173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720182173 NPI number — MRS. NICOLE P SPRINGER PHD LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPRINGER
Provider First Name:
NICOLE
Provider Middle Name:
P
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHD LMFT
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:
1720182173
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEAGUE CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77574
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-989-8640
Provider Business Mailing Address Fax Number:
281-316-2471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18333 EGRET BAY BLVD
Provider Second Line Business Practice Location Address:
STE 270
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-335-3640
Provider Business Practice Location Address Fax Number:
281-316-2471
Provider Enumeration Date:
09/07/2006

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: 106H00000X , with the licence number:  4791 , 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: 00220B . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7822385 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10008924 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 416877 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".




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