1811961865 NPI number — MEXIA MANAGEMENT CO.

Table of content: (NPI 1811961865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811961865 NPI number — MEXIA MANAGEMENT CO.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEXIA MANAGEMENT CO.
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:
6
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:
1811961865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 E SUMPTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEXIA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76667-2354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-562-5543
Provider Business Mailing Address Fax Number:
254-562-2206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 E SUMPTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEXIA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76667-2354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-562-5543
Provider Business Practice Location Address Fax Number:
254-562-2206
Provider Enumeration Date:
02/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
CHELSIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
254-562-3999

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  4303 , 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: 000430308 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com