1801365366 NPI number — DEBONS BUSINESS MANAGEMENT INC D/B/A JOE PIL

Table of content: (NPI 1801365366)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801365366 NPI number — DEBONS BUSINESS MANAGEMENT INC D/B/A JOE PIL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEBONS BUSINESS MANAGEMENT INC D/B/A JOE PIL
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:
1801365366
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8030
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HORSESHOE BAY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78657-8030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-690-7455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6909 W FM 2147
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HORSESHOE BAY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78657-6434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-690-7455
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DEBONS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
806-690-7455

Provider Taxonomy Codes

  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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