1841704970 NPI number — DR. IRENE VAL-ADDO DC

Table of content: DR. IRENE VAL-ADDO DC (NPI 1841704970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841704970 NPI number — DR. IRENE VAL-ADDO DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAL-ADDO
Provider First Name:
IRENE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
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:
1841704970
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 700688
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78270-0688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-404-6050
Provider Business Mailing Address Fax Number:
866-313-3397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 BRAND STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75094-3726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-404-6050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2017

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: 111N00000X , with the licence number:  13546 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111NR0400X , with the licence number: 13546 , 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: 13546 . This is a "TEXAS BOARD OF CHIROPRACTIC EXAMINERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 13546 . This is a "CHIROPRACTIC LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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