1780832154 NPI number — MRS. CHERYL LYNNE CASE RD, LD, CDE

Table of content: MRS. CHERYL LYNNE CASE RD, LD, CDE (NPI 1780832154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780832154 NPI number — MRS. CHERYL LYNNE CASE RD, LD, CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASE
Provider First Name:
CHERYL
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD, LD, CDE
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:
1780832154
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13100 NORTHWEST FREEWAY
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-237-3500
Provider Business Mailing Address Fax Number:
281-897-9906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10970 SHADOW CREEK PKWY SUITE 270
Provider Second Line Business Practice Location Address:
DIABETES AMERICA PERLAND OFFICE
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-840-5210
Provider Business Practice Location Address Fax Number:
713-436-7721
Provider Enumeration Date:
08/28/2008

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: 133VN1006X , with the licence number:  DT05898 , 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)





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