1831580166 NPI number — ARDEMAIK SURGICAL SERVICES

Table of content: (NPI 1831580166)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831580166 NPI number — ARDEMAIK SURGICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARDEMAIK SURGICAL SERVICES
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:
1831580166
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10935 ALMEDA GENOA RD
Provider Second Line Business Mailing Address:
P.O. BOX 34551
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77034-9998
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-653-2924
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10935 ALMEDA GENOA RD
Provider Second Line Business Practice Location Address:
POB 34551
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77034-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-653-2924
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ TAMAYO
Authorized Official First Name:
ELSIDA
Authorized Official Middle Name:
MARGARITA
Authorized Official Title or Position:
SURGICAL ASSISTANT
Authorized Official Telephone Number:
281-653-2924

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , with the licence number:  SA00445 , 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: SA00445 . This is a "TEXAS MEDICAL BOARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com