1750667705 NPI number — NATIONAL HOUSE CALL PRACTITIONERS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750667705 NPI number — NATIONAL HOUSE CALL PRACTITIONERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL HOUSE CALL PRACTITIONERS
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:
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:
1750667705
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1526 COLE BLVD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80401-3410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-548-1194
Provider Business Mailing Address Fax Number:
303-423-7004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7710 RIALTO BLVD
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78735-8579
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-288-0859
Provider Business Practice Location Address Fax Number:
512-301-4821
Provider Enumeration Date:
10/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
502-596-7563

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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