1750790200 NPI number — ARACILY BRIONES-GONZALES

Table of content: ABIGAIL GRACE BELFORD PHARMD (NPI 1134953037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750790200 NPI number — ARACILY BRIONES-GONZALES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRIONES-GONZALES
Provider First Name:
ARACILY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1750790200
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3120 SOUTHWEST FWY
Provider Second Line Business Mailing Address:
SUITE 612
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77098-4509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-979-3800
Provider Business Mailing Address Fax Number:
713-979-3806

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 NE LOOP 820; BUSINESS TOWER1
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HURST
Provider Business Practice Location Address State Name:
UNITED STATES
Provider Business Practice Location Address Postal Code:
76053
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
817-292-8787
Provider Business Practice Location Address Fax Number:
817-789-6849
Provider Enumeration Date:
08/08/2014

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: 225200000X , with the licence number:  2052493 , 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)